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149 Federal Street 1-3-18 1100 Crown Colony Drive RECEIVED P.O.Box 699195 �� Quincy,MA 02269-9195 OCTARBELL �O'$ 617.328.2800 INSURANCE GROUP arbella.com BOARD OF HEALTH October 5, 2018 SALEM BUILDING COMMISSIONER SALEM CITY HALL 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 033968313 Policy Number: Enter Policy Number Company Name: Arbella Mutual Insurance Company Date of Loss: 01/03/2018 Insured: DOUGLAS MCGUIRK Property Location: 149 FEDERAL STREET, SALEM 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 313 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, Douglas McGuirk Claim Service Specialist Property Claim Office 800-272-3552 ext. 2454 Fax 617-773-4760 CC: SALEM HEALTH DEPARTMENT SALEM CITY HALL 93 WASHINGTON STREET SALEM,MA 01970 CC: SALEM FIRE DEPARTMENT 48 LAFAYETTE STREET SALEM,MA 01970