4 ADMIRALS LN 140B _ DAMAGE LOSS CLAIM 1-18-2025 TRAVELERS
CLAIM PROFESSIONAL
City of Salem
Building Inspector
120 Washington Street
Salem, MA 01970
Claim Number1—{�I
IXE7618
January 22,2025
Dear City of Salem,
Date of loss
To: Board of Selectmen
Building Commissioner January 18,2025
Inspector of Buildings
Board of Health
A claim has been made involving loss,damage or destruction of the above
captioned property which may either exceed$1,000 or cause Massachusetts
eneral Law hap Pr 14 Senior,6 to be applicable.If any notice under LOSS location
Ma.%�gchusetts General Laws Chapter 139 Section 3B is appropriate,please direct 4 ADMIRALS LN 140 B
it to my attention and include a reference to our insured,the policy number,the
claim/file number,the date of loss,and the location. f SALEM MA 01970
Questions? Claimant name: Patrick Bailey
Insured name: PATRICK BAILEY
If you have any questions,please contact us. Underwriting Travelers Personal
Company: Security Insurance
Dn this date, I caused copies of this notice to be sent to the persons named above Company
at the addresses indicatedabove by first class mail.
signature Date
0062 7/21
M07m 2M aoeeoe CGEFMI 2WZ