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3 BECKFORD STREET 10-30-17 CLAIM RECEIVED LaMarche Associates 5 North Road, P.O. Box 250 JAN 16 2018 Chelmsford, MA 01824 800-349-1525 CITY OF SALEM Fax: 978-256-8590 BOARD OF HEALTH December 6, 2017 Building Commissioner/Inspector of Buildings SALEM, MA 01970-3205 Board of Health/Board of Selectmen SALEM, MA 01970-3205 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: HOLLY D. BARRETT Loss Location: 3 BECKFORD STREET SALEM, MA 01970-3205 Policy Number: H017059688 Date of Loss: 10/30/2017 Cause of Loss: Wind LA File Number: MA-2-33830 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. Kevin Lafrenais Adjuster LaMarche Associates,Inc.-800-349.1525 Page 1 of 1