125 MARLBOROUGH ROAD 8-21-25 CLAIM K]S INDEPENDENT RECEIVED
CLAIMS SERVICE, INC. AUG 25 2025
Service Integrity CITY OF SALEM Experience BOARD OF HEALTH
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
August 22, 2025
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: Alison O'Brien
ADDRESS: 125 Marllborough Rd, Salem,MA 01970
LOCATION OF LOSS: 125 Marllborough Rd, Salem,MA 01970
COMPANY: Vermont Mutual Insurance
POLICY#: HP00048344
CLAIM#: 25-99514
DATE OF LOSS: 08/21/2025
TYPE OF LOSS: Property Damage
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 508.366.091 7 • www.icsclaims.com