5-7 COUSINS ST_ NOTICE LOSS 8-28-25 Samuel F. McCormack Co., Inc.
Insurance Adjusters and Appraisers
SemW F.lkramixk Co.,Inc.
1uV87ENI AND wrMn[Ot
September 4, 2025
Salem City Hall
Building Inspector
93 Washington Street
Salem, MA 01970
RE ASSURED: The Cousins Street Condo Trust, c/o Barbara Kelley
LOSS LOCATION: 5-7 Cousins St, Salem, MA 01970
POLICY NO: BP28028992
TYPE OF LOSS: Water
DATE OF LOSS: 08/28/2025
OUR FILE NO: 25-01377
To Whom It May Concern:
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 any notice under Massachusetts General Laws, Chapter 139, Section 313 is
appropriate, please direct it to the attention of this writer and include a reference to the above-
captioned insured, location, policy number, date of loss and claim or file number.
Thank you for your anticipated cooperation.
Very
truly, yours ,
�%Nam' p
Edward Bennett
Adjuster
efb@mccormackadjuster.com
cc: Board of Health
Fire Department
42 Holbrook A venue,Braintree,MA 02184 1-800-972-5399(781)843-1222 Fax(781)849-8191
125 Waterhouse Road,Bourne,MA 02532(508)403-2600 Fax(508)403-2602
w .mccormackadjuster.com