10 BUFFUM ST_ CLAIM NOTICE 2.25.23 Samuel F. McCormack Co. Inc.
PM� Insurance Adjusters and Appraisers
Samuel F.M1kCNmlazk Co.,IRS.
ADJUSTERS AND APPRAISERS
February 27, 2023
Salem City Hall
Building Inspector
93 Washington Street
Salem, MA 01970
RE ASSURED: Thomas & Stephen Kapnis
LOSS LOCATION: 10 Buffum St, Salem, MA 01970
POLICY NO: DP00001928
TYPE OF LOSS: Water
DATE OF LOSS: 02/25/2023
OUR FILE NO: 23-01017
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 313 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,
Mike Daniels
Adjuster
md@mccormackadjuster.com
cc: Board of Health
Fire Department
42 HolhrookAvenue, 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,com