430 ESSEX STREET 2-4-26 CLAIM RECEIVED
INDEPENDENT FEB 102026
CLAIMS SERVICE, INC CITY OFSALEM
BOARD OF HEALTH
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
February 5, 2026
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: Igreja Evangelica Pentocostal O Bom Pastor Inc
ADDRESS: 2 Tremont St,Peabody,MA 01960
LOCATION OF LOSS: 430 Essex St, Salem ,MA 01970
COMPANY: Vermont Mutual Insurance
POLICY#: BP11028668
CLAIM#: 26-100653
DATE OF LOSS: 02/04/2026
TYPE OF LOSS: Freeze Up
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 01 581 • 508.366.8535 • FAX 508.366.091 7 • www.icsclaims.com