169 OCEAN AVE WEST_ DAMAGE LOSS CLAIM 2-11-2025 " INDEPENDENT
CLAIMS SERVICE, INC.
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws,Chapter 139,Section 3B
February 11, 2025
Salem, MA Building Inspector
1 Salem Green
Salem, MA 01970
Salem, MA Board of Health
9 North Street
Salem,MA 01970
Salem, MA Fire Department
48 Lafayette Street
Salem, MA 01970
INSURED: Fatima Islam
ADDRESS: 169 Ocean Ave W,Salem, MA 01970
LOCATION OF LOSS: 169 Ocean Ave W, Salem, MA 01970
COMPANY: Vermont Mutual Insurance
POLICY#: HP00188668
CLAIM#: 25-98355
DATE OF LOSS: 02/11/2025
TYPE OF LOSS: Sewerage
Dear Sir or Madam:
Independent Claims Service is the insurance adjusting firm hired by the above referenced client to handle the
captioned loss on behalf of their insured.
A 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
notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please bring it to our
attention, and include a reference of the captioned insured: Location, policy number, and/or date of loss.
Sincerely,
INDEPENDENT CLAIMS SERVICE, INC.
22 Water Street • Westborough.MA 01 581 • 508.366.8535 • FAX 508.366.0917 • www.icsclaims.com