24 STATION ROAD 11-28-24 CLAIM K]S INDEPENDENT RECEIVED
CLAIMS SERVICE, INC. DEC 112024
CITY OF SALEM
Service Integrity Experience BOARD OF HEA TH
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 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 508.366.091 7 • www.icsclaims.com