47 INTERVALE ROAD_ CLAIM NOTICE 8-24-25 THENORFOLKjkDEDHAMGROUP® -
chester Mutual Insurance Co. Fitchburg Mutual Insurance Co
Norfolk & Dedham Mutual Fire Insurance Co. Dor .
August 26, 2025
FORM OF NOTICE OF CASUALTY LOSS TO UNDER MASS. GEN. LAWS, CH 139, SEC. 3B BUILDING
Building Commissioner, or Inspector of Buildings
c/o City or Town Hall
93 Washington St.
Salem, MA 01970
Board of Health or Board of Selectmen
c/o City or Town Hall
93 Washington St.
Salem, MA 01970
Fire Department or Arson Squad
c/o City or Town Hall
93 Washington St.
Salem, MA 01970
RE: Our File No.: P2561820
Insured: ANTHONY MIGLIACCIO
Address: 47 INTERVALE RD, SALEM, MA
Policy No.: H2373007A
Loss Date: 08/24/2025
Loss Type: Building or Other Structure Damage
A 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, Ch. 143, Sec. 6 to be
direct
ed insured,
applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. , location, policy number, loss
is appropriate, please
it to my attention and include a reference to the caption
date and claim or file number.
officeIf no reply is received from your
will assume you
type against this property and the claim within
I be paid in our e customarymannerave no liens of any.
Sincerely,
Deborah Hopkinson
Sr. Staff Appraiser/Adjuster
1-800-688-1825 x1713 w^
1�•
Home Office SINCE 1825
222 Ames Street,P.O. Box 9100
Dedham,MA 02027.9109
Phone:(800)688.1825