9 CLARK AVE_ CLAIM 7.14.22 /ffj[ CLAIM P
ur 101 HIGHSTREE7, P O. BOX 40, NORWICH, CT 06360 FOUNDED 1840
(860)887-3553-CT 1-800-962-0800-MA-RI 1-800-243-4080-FAX(860)886-8270-www.n1ansurance.com
July 19, 2022
Inspector of Buildings
120 Washington St. 3rd Fir
Salem, MA 01970
SUBJECT: Insured: Liliana Damato
Property Address: 9 Clark Ave, Salem, MA 01970
Policy Number: 15221047HO
Date of Loss: 07/14/22
Claim Number: 22HI001203
To Whom It May Concern:
A 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 313 is appropriate,
please direct it to the attention of the writer and include reference to the captioned insured, location,
policy number, date of loss, and claim number.
On this date, copies of this notice have been sent by first class mail to the municipal officials for the
property address listed above.
Sincerel ,
S ' -
cc: Joan S. Haling
` 4:0
, i;