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18 AMERICA WAY 11-1-23 CLAIMLaMarche Associ ates, I nc. - 800-222-0143Page 1 o f 1 LaMarche Associates 5 North Road, P.O. Box 250 Chelmsford, MA 01824 978-256-8586 Fax: 978-256-8590 Nov ember 8, 2023 Building Commisioner/Inspector of Buildings Salem, MA 01 970-665 2 Fire Department/Arson Squad Salem, MA 01 970-665 2 Board of Health/Board of Selectmen Salem, MA 01 970-665 2 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSA C H USETTS GEN ER AL LAW S, CH APTER 13 9 , SEC TI ON 3 B Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed $1,000.00 or cause Massachuse tts Ge ne ral Laws, Chapte r 143 , Se ction 6 to be applicable. If any notice under Massachuse tts Ge ne ral Laws, Chapte r 1 39, Se ction 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss, cause of loss and LA file number. Insured:Evelyn Hoffman Loss Location:18 America Way #5 Salem, MA 0 197 0-66 52 Policy Number:HP00172016 Date of Loss:11 /01/2023 Cause of Loss:Water LA File Number:MA-2-4373 0 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. Connor Dooley Adjuster