1 Brooks Street 3-1-21 claim RECEIVED LaMarche Associates
5 North Road, P.O. Box 250
MAR 0 8 2021 Chelmsford, MA 01824
CITY OF SALEM 800-349-1525
BOARD OF HEALTH Fax: 978-256-8590
March 2, 2021
Building Commissioner/Inspector of Buildings
Salem, MA 01970
Board of Health/Board of Selectmen
Salem, MA 01970
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 Cha ter
143 Section 6 to be applicable. If any notice under Massachusetts General Laws Cha ter
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: Geoffrey Blass
Loss Location: 1 Brooks Street
Salem, MA 01970
Policy Number: 15222282HO
Date of Loss: 03/01/2021
Cause of Loss: Wind
LA File Number: MA-2-39.187
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,
Brian Aspell
Adjuster
LaMarche Associates,Inc.-800-349-1525
PagelofI