25 CRESCENT DR_ CLAIM NOTICE 12.20.23 Claims Department 75 Sam Fonzo Drive I Beverly, Massachusetts 01915
800.227.2757 I Electriclnsurance.com
December 20, 2023
Building Commissioner or
Inspector of Buildings
98 Washington St
Salem, MA 01970
RE: Insured: KATHLEEN VANRIPER
Claim Number: 20231220A09
Policy Number: H6040601H1
Date of Loss: December 20, 2023
Property Address: 25 CRESCENT DR SALEM, MA 01970-1236
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 3B 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 December 20, 2023 copies of this notice were sent by first class mail to the entities and addresses
noted herein.
Sincerely,
r404bt w SaKtle�
Andrew Sanchez
Claims Specialist