4 Lincoln Road 10-17-19 claim RECEIVED 1100 Crown Colony Drive
P.O.Box 699195
02269-9195
A R B :E L LA Nov 0 7 Z019 Quincy,MA 617.328.2800
INSURANCE GROUP arbella.com
CITY OF SALEM
BOARD OF-HtAt-fl
November 2, 2019
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034066176
Policy Number: 37035400004
Company Name: Arbella Mutual Insurance Company
Date of Loss: 10/17/2019
Insured: ROBERT BUTTERS
Property Location: 4 LINCOLN RD, 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,
Emily Migre
Claim Service Specialist
Property Claim Office
800-272-3552 ext. 7369
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