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81 LORING AVE _ CLAIM 3.31.24 Samuel F. McCormack Co., Inc. Insurance Adjusters and Appraisers Samuel F.Akfulmeck Co.,Inc. AWNTEP8 AND APPRAISERS April 12, 2024 Salem City Hall Building Inspector 93 Washington Street Salem, MA 01970 RE ASSURED: Luong&Phuong Nguyen LOSS LOCATION: 81 Loring Ave, Salem, MA 01970 POLICY NO: DP0O003627 TYPE OF LOSS: Puff back DATE OF LOSS: 03/31/2024 OUR FILE NO: 24-00950 To Whom It May Concern: 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 3113 is appropriate, please direct it to the attention of this writer and include a reference to the above- captioned insured, location, policy number, date of loss and claim or file number. Thank you for your anticipated cooperation. Very truly yours,4�40*5:_ Paxton Cogswell Adjuster pcogswell@mccormackadjuster.com cc: Board of Health Fire Department 42 Holbrook Avenue,Braintree,MA 02184 1-800-972-5399(781)843-1222 Fax(781)849-8191 125 Waterhouse Road,Bourne,MA 02532(508)403-2600 Fax(508)403-2602 www.mccormackadjuster.cam