6 BORDER STREET_DAMAGE LOSS CLAIM 12-1-2024 Safety Insurance%
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December 5, 2024
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectmen
City Hall
SALEM, MA 01970
RE: Claim Number: LHMA04C1F2
Insured(s): WILLIAM HOSMAN
Property Address: 6 BORDER ST, SALEM, MA 01970
Policy Number: HMA0606358
Date of Loss: 12/1/2024
Notice of Loss Under M.G.L. c. 139, 6 3B
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above-reference address which may either: (1) meet or exceed
$1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143 § 6
applicable.
In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed
to perfect a lien under Section 36, M.G.L. c. 143, §9 or M.G.L. c. 111, § 127B, please notify Safety
of the same by certified mail. Kindly forward such notice to my attention, at the address indicated
above, and include with such notice a reference to the above-described insured, property address,
policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly by email at
7-951
billyleon@safetyinsurance.com or by phone at 61 -0600 extension 5207.
Sincerely,
Billy Leon
Claims Adjuster
Visit us at a .safetyinsurance.com/claims for Frequently Asked Claims Questions
Safety Insurance P.O.Box 55098 Boston,MA 02205-5098 800-951-2100
Well help you manage life's stormsO U 010_C139
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