24 STATION ROAD_ DAMAGE LOSS CLAIM 11-28-2025 " INDEPENDENT
CLAIMS SERVICE, INC.
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws,Chapter 139,Section 3B
December 2, 2024
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: Colin & Nikki Schafer
ADDRESS: 24 Station Road, Salem,MA 01970-4435
LOCATION OF LOSS: 24 Station Road,Salem, MA 01970-4435
COMPANY: Vermont Mutual Insurance
POLICY#: HP00036891
CLAIM#: 24-97822
DATE OF LOSS: 11/28/2024
TYPE OF LOSS: Fire
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 313 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.icsdaims.com