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35 FELT STREET 11-1-25 CLAIM Phone: 978-632-2660 Fax: 978-632-2662 RECEIVED NOV 0 6 2025 TRUDEAU ADJUSTMENT SERVICE P.O.Box 7 CITY OF SALEM Gardner,MA 01440 BOARD OF HEALTH claims(a�trudeauad&M Notice of Casualty Loss of Buildint_ Under Massachusetts General Laws, Chapter 139,Section 311 11/03/2025 Building Inspector Salem Building Dept. 93 Washington Street Salem,MA 01970 Board of Health Salem Health Dept. 93 Washington Street Salem,MA 01970 Fire Department Salem Fire Dept./Dept.of Records 48 Lafayette Street Salem,MA 01970 Insured: Michael Donnor Date of Loss: 11/01/2025 Type of Loss: Fire Loss Location: 35 Felt St.,Salem,MA 01970-2435 Policy No: 1807723 File No.: 25-21131 Claim No.: 0030120986 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, Chapter 139,Section 3B"is appropriate,please direct it to the writer and include a reference to the captioned insured,location, policy number,date of loss,and file or claim number. On this date,I cause copies of this notice to be sent to the person(s)named above at the address indicated by first class mail. Sincerely, Michael Williams Claims Adjuster