64 Marlborough Rd_ Claim Notice_ 8.4.22 AML
Claims Department 75 Sam Fonzo Drive I Beverly,Massachusetts 01915
800.227.2757 1 Electriclnsurance.com
August 5, 2022
Building Commissioner or
Inspector of Buildings
98 Washington St
Salem, MA 01970
RE: Insured: ROGER LEGER
Claim Number: 20220805A10
Policy Number: H5A01078H1
Date of Loss: August 04, 2022
Property Address: 64 MARLBOROUGH RD SALEM, MA 01970-1855
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 313 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 August 5, 2022 copies of this notice were sent by first class mail to the entities and addresses noted
herein.
Sincerely,
'40twtew 5"dltej
Andrew Sanchez
Claims Specialist
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