12 MALL STREET 12-27-23 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
January 27, 2024
Building Commisioner/Inspector of Buildings
Salem, MA 01 970-338 6
Fire Department/Arson Squad
Salem, MA 01 970-338 6
Board of Health/Board of Selectmen
Salem, MA 01 970-338 6
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:12 Mall Street Condominium
Loss Location:12 Mall Street
Salem, MA 0 197 0-33 86
Policy Number:BO213330
Date of Loss:12 /27/2023
Cause of Loss:Mold Damage
LA File Number:MA-2-4417 5
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.
Dav id Montgomery
Adjuster