INS. LOSS LTR. �IECTR/C
75 Sam Fonzo Drive I Beverly, Massachusetts 01915
INSURANCE' Claims Department
Cps 'ANV
800.227.2757 I Electriclnsurance.com
P
March 2, 2020
Building Commissioner or
Inspector of Buildings
98 Washington Street
Salem, Massachusetts 01970
RE: Insured: Stephanie Ellis
Claim Number: 20200302017
Policy Number: 6483668H1
Date of Loss: March 01, 2020
Property Address: 7 N PINE ST SALEM, MA 01970
Form of Notice of Casualty Loss to Building
Under Massachusetts General Laws Chapter 139, Sec. 3B
Claim has been made involving loss, damage or destruction to the above-captioned property, which may
equal or exceed $1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable.
If any notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please direct to
the attention of the undersigned and include a reference to the captioned insured, location, policy
number, date of loss and claim or file number.
On March 2, 2020 copies of this notice were sent by first class mail to the entities and addresses noted
herein.
Sincerely,
Vevzic4�za�i�Jt
Derrick Frazier
Claims Specialist