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27 Settlers Way_ Claim Notice 10.15.23 AdIllikk IMsafety insurance° AUTO•HOME.BUSINESS October 18, 2023 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: LHMA02E5DA Insured(s): SUSAN FASOLI Property Address: 27 SETTLERS WAY, SALEM, MA 01970 Policy Number: HMA0485296 Date of Loss: 10/15/2023 Notice of Loss Under M.G.L. c. 139, 4 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, § 3B, 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 LTsaMohette@Safetylnsurance.com or by phone at 800-951-2100 extension 3420. Sincerely, Lisa Monette Property Claims Field Adjuster Visit us at w .safetyinsurance.com/claims for Frequently Asked Claims Questions Safety Insurance P.O. Box 55098 Boston, MA 02205-5098 800-951-2100 Well help you manage life's stormsO a n ® 0 oio_cias 23