125 MARLBOROUGH ROAD_ CLAIM NOTICE 8-21-25 " INDEPENDENT
CLAIMS SERVICE, INC.
Service Integrity • Experience
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#: RP0O048344
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 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 01581 • 508.366.8535 • FAX 508.366.0917 • www.icsclaims.com