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35 FORRESTER ST UNIT 2_ CLAIM 7.10.22 ImSafety Insurance AUTO•HOME•BUSINESS July 17, 2022 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: LHMA01185D Insured(s): MARYANNE CURTIN Property Address: 35 FORRESTER ST UNIT 2, SALEM, MA 01970 Policy Number: HMA0273576 Date of Loss: 7/10/2022 Notice of Loss Under M.G.L. C. 139, 6 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, § 36, 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 --LisaMonette@,Safetylnsurance.com or by pi rone at 800-951-2100 extension 342&.- Sincerely, Lisa Monette Property Claims Field Adjuster JUL 42'rM1(1:19 Visit us at w .safetyinsurance.com/claims for Frequently Asked Claims Questions J L IU ? Safety Insurance P.O.Box 55098 Boston,MA 02205-5098 800-951-2100 We'll help you manage life's stormsO C1 H ® ® 010 C139 374