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14 BEACON STREET 8-15-16 CLAIM 1100 Crown Colony Drive t P.O.Box 699195 .A R B E L L A� Quincy,MA 02269-9195 617.328.2800 INSURANCE GROUP arbella.com RE-CEIVED July 23, 2018 JUL 2 5 2018 SALEM BUILDING COMMISSIONER CITY OF SALEM SALEM CITY HALL BOARD OF HEALTH 93 WASHINGTON STREET SALEM, MA 01970 Claim Number: 033948136 Policy Number: 88979400001 Company Name: Arbella Mutual Insurance Company Date of Loss: 08/15/2016 Insured: WALTER KEENAN Property Location: 1413EACON 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, Douglas McGuirk Claim Service Specialist Property Claim Office 800-272-3552 ext. 2454 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