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37 DEARBORN STREET 6-20-24 CLAIM P.O. Box 2487 Woburn, MA 01888 P: (781) 755-8554 F: (781) 757-0885 claims@benchmarkclaims.com 6/21/2024 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B City of Salem Town Hall Building Inspector Salem, MA 01970 City of Salem Town Hall Health Inspector Salem, MA 01970 Salem Fire Department Salem, MA 01970 Insured: Owen H. Myers & Josephine P. Cutts Address: 37 Dearborn Street, Salem, MA 01970 Policy No.: 13199428 Date of Loss: 6/20/2024 Origin: Wind Our File No.: 24-296-PT Claim has been made involving loss, damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Chapter 143, Section 6 to be applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number. If no reply is received from your office within ten days, we will assume you have no liens of any type against this property and we will recommend to the insuring company that this claim is paid. Sincerely, Brad Doherty Brad Doherty Owner