11 CHURCH ST UNIT 123_ CLAIM Samuel F. McCormack Co. Inc.
Insurance Adjusters and Appraisers
Samuel F. 9k Co.,In.
TOASTERS AND 1Mp AP RPPRAI9fR9
April 4, 2023
Salem City Hall
Building Inspector
93 Washington Street
Salem, MA 01970
RE ASSURED: Joanne O'Keefe
LOSS LOCATION: 11 Church St Unit 123, Salem, MA 01970
POLICY NO: HP00136002
TYPE OF LOSS: Water
DATE OF LOSS: 04/03/2023
OUR FILE NO: 23-01305
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 Massachusetts General Laws, Chapter 143, Section 6 to
be applicable. If any notice under Massachusetts General Laws, Chapter 139, Section 3B is
appropriate, please direct it to the attention of this writer and include a reference to the above-
captioned insured, location, policy number, date of loss and claim or file number.
Thank you for your anticipated cooperation.
Very
truly yours '
Edward Bennett
Adjuster
efb@mccormackadjuster.com
cc: Board of Health
Fire Department
42 Holbrook A venue,Braintree,MA 021841-800-972-5399(781)843-1222 Fax(781)849-8191
125 Waterhouse Road,Bourne,MA 02532(508)403-2600 Fax(508)403-2602
w -mccormackadjuster.com