13 1/2 Meadow Street 8-23-19 claim RECEIVED 1100 Crown Colony Drive
P.O.Box 699195
2269-9195
.�A►.R B E L L A� S EP �i 4 2019 Quincy,MA 61 7.328.2800
'sysuR,awcE GROUP CITY OF SALEM arbella.com
SCAR❑ OF-HEALTH
September 18, 2019
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
93 WASHINGTON STREET
SALEM, MA 01970
Claim Number: 034056463
Policy Number: 33974400006
Company Name: Arbella Mutual Insurance Company
Date of Loss: 08/23/2019
Insured: MATTHEW PETERSON
Property Location: 13.5 MEADOW ST, 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