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85 Tremont Street 5-4-21 claim RECEIVED LaMarche Associates 5 North Road, P.O. Box 250 MAY 10 ZOZ1 Chelmsford, MA 01824 800-349-1525 CITY OF SALEM Fax: 978-256-8590 BOARD OF HEALTH May 4, 2021 Building Commissioner/Inspector of Buildings Salem, MA 01970-1529 Board of Health/Board of Selectmen Salem, MA 01970-1529 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, which may either exceed $1,000.00 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 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: Alaide Picanco Loss Location: 85 Tremont Street Salem, MA 01970-1529 Policy Number: HO12250303 Date of Loss: 05/04/2021 Cause of Loss: Vehicle LA File Number: MA-2-39447 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. Matthew Rosenbaum Adjuster LaMarche Associates,Inc.-900-349-1525 Page 1 of 1