11 BENGAL LANE 6-12-18 CLAIM LaMarche Associates
RECEIVED
5 North Road, P,O. Box 250
Chelmsford, MA 01824
JUN 18 2018 800-349-1525
Fax: 978-256-8590
CITY OF SALEM
BOARD OF HEALTH June 13, 2018
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,
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: Susan Gallant
Loss Location: 11 Bengal Lane
Salem, MA 01970
Policy Number: HP009232313
Date of Loss: 06/12/2018
Cause of Loss: Water
LA File Number: MA-2-35130
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.
Kris Kirkpatrick
Adjuster
LaMarche Associates,Inc.-800-349-1525
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