2 BENTLEY ST Safety Insurance
7' AUTO.HOME•BUSINESS
June 7, 2023
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectmen
City Hall
SALEM, MA 01970
RE: Claim Number: LHMA025490
Insured(s): LINDA MOUSTAKIS
Property Address: 2 BENTLEY ST, SALEM, MA 01970
Policy Number: HMA0419340
Date of Loss: 5/1/2023
Notice of Loss Under M.G.L. c. 139. 4 3B
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above-reference address which may either: (1) meet or exceed
$1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143 § 6
applicable.
In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed
to perfect a lien under Section 3B, M.G.L. c. 143, §9 or M.G.L. c. 111, § 127B, please notify Safety
of the same by certified mail. Kindly forward such notice to my attention, at the address indicated
above, and include with such notice a reference to the above-described insured, property address,
policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly by email at
LisaMoliette@Safetyinsurance.comut by phone-ab800-951-2100 extension 342E3:
Sincerely,
Lisa Monette
Property Claims Field Adjuster
Visit us at w .safetyinsurance.comiclaims for Frequently Asked Claims Questions
Safety Insurance P.O.Box 55098 Boston, MA 02205-5098 800-951-2100
We'll help you manage life's stormsO
O10_C139
i