96 WASHINGTON SQ UNIT 1_CLAIM .. t Michael Winston & Associates, LLC
Innovative Risk Specialists
"e POB 287
Salem, NH 03079
Tel: 603-494-2366 - Fax: 888-306-8106 - E-mail: michaelwinston@comcast.net
January 17, 2023
Salem Town Clerk
93 Washington Street
Salem, MA 01970
Please distribute to each of these departments, to comply with the reporting requirements of MGL Chapter 139,
Section 3B and MGL Chapter 143 Section 6.
TO: [X] Building Commissioner or Inspector of Buildings
[X] Board of Health or Board of Selectmen
[X] Fire Department
RE: Sue Ellen Costarino
Overlook Common Condo
96 Washington Square, Unit 1
Salem, MA 01970
Type of Loss: Sewer Overflow
Date of Loss: January 9, 2023
Policy: BP21012859
Claim number: B0014008
Our File#: M W23-014 Location of Loss: Same
To whom it may concern:
Claim has been made involving loss, damage or destruction of the above captioned property,which may either
exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL,
Chapter 139, Section 3B is appropriate, please direct it to the attention of this writer and include a reference to the
captioned insured, location, policy number,date of loss and file number. On this date, I caused copies of this notice
to be sent to the persons named above at the addresses indicated above by First Class Mail.
Sincerely,
z%
Michael Winston
Adjuster
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