176 OCEAN AVE W_ 1.10.24_ CLAIM r�jClaims Department 75 Sam Fonzo Drive I Beverly,Massachusetts 01915
800.227.2757 1 Electriclnsurance.com
January 10, 2024
Fire DepartmenUArson Squad
48 Lafayette St
Salem, MA, 01970
RE: Insured: FREDERICK GAFFNEY
Claim Number: 20240110A06
Policy Number: H6469471H1
Date of Loss: January 10, 2024
Property Address: 176 OCEAN AVE W SALEM, MA 01970-2919
Form of Notice of Casualty Loss to Building
Under Massachusetts General Laws Chapter 139, Sec. 3B
Claim has been made involving loss, damage or destruction to the above-captioned property, which may
equal or exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable.
If any notice under Massachusetts General Laws, Chapter 139, Section 36 is appropriate, please direct to
the attention of the undersigned and include a reference to the captioned insured, location, policy
number, date of loss and claim or file number.
On January 10, 2024 copies of this notice were sent by first class mail to the entities and addresses noted
herein.
Sincerely,
Z4 Saff&e s
Lily Sullivan
Claims Specialist