31 FORRESTER STREET 7-10-26 CLAIMLaMarche Associ ates, I nc. - 800-222-0143Page 1 o f 1
LaMarche Associates
P.O. Box 840
Palmer, MA 01069
413-289-1243
Fax: 413-289-1249
July 10, 2026
Building Commisioner/Inspector of Buildings
Salem, MA 01 970-403 7
Fire Department/Arson Squad
Salem, MA 01 970-403 7
Board of Health/Board of Selectmen
Salem, MA 01 970-403 7
NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASSA C H USETTS GEN ER AL LAW S, CH APTER 13 9 , SEC TI ON 3 B
Claim has been made involving loss, damage or destruction of the property captioned below,
which may either exceed $1,000.00 or cause Massachuse tts Ge ne ral Laws, Chapte r 143 ,
Se ction 6 to be applicable. If any notice under Massachuse tts Ge ne ral Laws, Chapte r 1 39,
Se ction 3B is appropriate, please direct it to the attention of the writer and include a reference to
the captioned insured, location, policy number, date of loss, cause of loss and LA file number.
Insured:Mary Madore
Loss Location:31 Forrester Street
Salem, MA 0 197 0-40 37
Policy Number:Hp00128972
Date of Loss:07 /10/2026
Cause of Loss:Water
LA File Number:MA-2-4694 8
On this date, I caused copies of this notice to be sent to the persons named above at the
addresses indicated above by first class mail.
Andrew West
Adjuster