1 HIBERNIA LN_ NOTICE OF LOSS 3-12-25 •0000180
Liberty Mutual Fire Insurance Company
P.O. Box 5014 Liberty Mutual.
Scranton PA 18505-5014 INSURANCE
CONTACT US
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City of Salem m
93 Washington St
Salem, MA, 01970-3527 Direct: (978) 59
8-884
Fax: (888) 268-8840
Liberty Mutual Fire Insurance
Company
P.O. Box 5014
Scranton PA 18505-5014
United States
(800) 225-2467
March 13, 2025 LibertyMutual.com
ATTN
Insured: JAMES J. FALLON
Policy Number: H62-21 8-1 7 31 86-21
Claim Number: 058962182-01
Date of Loss: 03/12/2025
Loss Location: 1 HIBERNIA LN, SALEM, MA 01970-6821
To Whom It May Concern,
Pursuant to M.G.L. c. 139, §3B, please be aware that a homeowners insurance claim has been made
involving loss, damage or destruction of the above captioned property, which may either exceed
$1,000.00 or causes the condition of a building or other structure to render Mass. General Laws, Ch. 143,
§6 applicable. You are required to notify Liberty Mutual by certified mail in accordance with Mass.
General Laws Ch. 175, §99, if you intend to initiate proceedings designed to perfect a lien pursuant to
S Mass. General Laws, Ch. 139, § 3A& B, or Mass. General Laws, Ch. 143, §9, or Mass. General Laws,
Ch. 111, § 127B.
This letter should not be construed as a waiver or estoppel of any of the terms, conditions or defenses
S afforded by the policy or applicable law. Please direct your notice to the attention of the undersigned and
include a reference to the above captioned property address, policy number, claim number, and date of
g feel free to contact me, either by phone or by email.
loss. If you have any questions or concerns, please
o When contacting me by email, please include the claim number in the subject line.
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Sincerely,
KIMBERLY DOW
Claims Department
MAL2020A Massachusetts Property Lien Letter 058962182-01 Page 1 of 1