9 Dunlap Street 10-30-17 claim RECEIVED LaMarche Associates
5 North Road, P.O. Box 250
DEC 0 62017 Chelmsford, MA 01824
800-349-1525
CITY OF SALEMFax: 978-256-8590
BOARD OF HEALTH November 7, 2017
Building Commissioner/Inspector of Buildings
SALEM, MA 01970-2311
Board of Health/Board of Selectmen
SALEM, MA 01970-2311
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: GEORGE & BILLIE JEAN ANDERSON
Loss Location: 9 DUNLAP STREET
SALEM, MA 01970-2311
Policy Number: H017070453
Date of Loss: 10/30/2017
Cause of Loss: Physical Damage
LA File Number: MA-2-33713
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.
Bryan Thomas
Adjuster
1-allaaM1e Associates,Inc-800-349-1535
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