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9 Fortune Way_Claim TRAVELERSJ� MURPHYSERAFINO CLAIM PROFESSIONAL City of Salem Building Inspector 120 Washington Street Salem, MA 01970 Claim Number IMV4470 January 27,2023 Dear City of Salem Building Inspector, Date of IOSS To: Board of Selectmen January 26,2023 Building Commissioner Inspector of Buildings Board of Health A claim has been made involving loss,damage or destruction of the above captioned property which may either exceed$1,000 or cause Massachusetts Loss location mineral Laws Chapter 143 Section 6 to be applicable. If any notice under Massachusetts GeneLal Laws Chapter 139,Section 3B is appropriate,please direct 9 FORTUNE WAY it to my attention and include a reference to our insured,the policy number,the SALEM MA 01970 claim/file number,the date of loss,and the location. Questions.? Insured name: CAROL BARRY Underwriting THE TRAVELERS If you have any questions,please contact us. Company: HOME AND MARINE On this date,I caused copies of this notice to be sent to the persons named above INSURANCE at the addresses indicated above by first class mail. COMPANY Signature Date -PB 7rw12:52 IFS_ 10062 7/21 IF C0107000700 WMI CGEFCT l20 8