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3 Devereaux Ave_ Claim 2-16-2025 Samuel F. McCormack Co., Inc. Insurance Adjusters and Appraisers 3n,1 F.Ikrm,d G.,h. •ueSTln All uraneu February 18, 2025 Salem City Hall Building Inspector 93 Washington Street Salem, MA 01970 RE ASSURED: Ellen Dubinsky LOSS LOCATION: 3 Devereaux Ave, Salem, MA 01970 POLICY NO: HP00147634 TYPE OF LOSS: Water DATE OF LOSS: 02/16/2025 OUR FILE NO: 25-00266 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 3B 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, Edward Bennett Adjuster efb@mccormackadjuster.com cc: Board of Health Fire Department 41 Holbrook Avenue,Braintree,MA 021841-800-972-5399(781)843-1222 Fax(781)849-8191 125 Waterhouse Road,Bourne,MA 02532(508)403-2600 Fax(508)403-2602 - - w .mccormackadjuster.cont -