4-3-18 Claim 1100 Crown Colony Drive
P.O.Box 699103
Quincy,MA 02269-9103
A R B E L L A 617.328.2800
INSURANCE GROUP azbella.com
April 3, 2018 RECEIVED
SALEM BUILDING COMMISSIONER APR 0 5 2018
SALEM CITY HALL CITY OF SALEM
93 WASHINGTON STREET BOARD OF HEALTH
SALEM, MA 01970
Claim Number: 033913594
Policy Number: 35544400002
Company Name: Arbella Mutual Insurance Company
Date of Loss: 03/18/2018
Insured: MARGARET GAUDET
Property Location: 14 SHILLABER ST, SALEM, MA
To Whom It May Concern:
A claim has been made involving loss, damage, or destruction of the above captioned property, which
may either exceed$1,000 or cause Massachusetts General Laws, Chapter 143, Section 6, to be
applicable.
If any notice under Massachusetts General Law, Chapter 139, Section 3B is appropriate, please direct it
to the attention of the writer. Please include a reference to the captioned insured, location, date of loss
and claim number.
Thank you for your assistance.
Sincerely,
Mark Frechette
Claim Technical Specialist
Property Claim Office
800-272-3552 ext. 2203
Fax 617-773-4760
CC: SALEM HEALTH DEPARTMENT
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
CC: SALEM FIRE DEPARTMENT
4 8 LAFAYETTE STREET
SALEM,MA 01970