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6 Summit Avenue 7-19-18 claim RECEIVED LaMarche Associates 5 North Road, P.O. Box 250 JUL 3 12018 Chelmsford, MA 01824 800-349-1525 CITY OF SALEM Fax: 978-256-8590 BOARD OF HEALTH July 20, 2018 Building Commissioner/Inspector of Buildings Salem, MA 01970-4719 Board of Health/Board of Selectmen Salem, MA 01970-4719 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: David, Joann & Jessica Huckins Loss Location: 6 Summit Avenue Salem, MA 01970-4719 Policy Number: HP628892 Date of Loss: 07/19/2018 Cause of Loss: Water LA File Number: MA-2-35266 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 Gabbett Adjuster LaMarche Associates,Inc.-800-349-1525 Page 1 of 1