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14-16 Park Street 7-11-20 claim LaMarche Associates 5 North Road, P.O. Box 250 Chelmsford, MA 01824 800-349-1525 Fax: 978-256-8590 July 20, 2020 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 313 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., Chanter 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: Frank Valentino Loss Location: 14-16 Park Street Salem, MA 01970 Policy Number: BP21040349 Date of Loss: 07/11/2020 Cause of Loss: Water LA File Number: MA-2-38190 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. Tony Rossetti pp Adjuster R LCCI Y ED J U L 10 2020 CITY OF SALEM BOARD OF HEALTH LaMarche Associates,Inc.-800-349-1525 Page 1 of 1