17 Rockdale Avenue 3-2-18 claim LaMarche Associates
5 North Road, P.O. Box 250
Chelmsford, MA 01824
800-349-1525
Fax: 978-256-8590
March 15, 2018
RECEIVED
Building Commissioner/Inspector of Buildings MAR 19 2018
Salem, MA 01970
CITY OF SALEM
Board of Health/Board of Selectmen BOARD OF HEALTH
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: William & Carol Kenney
Loss Location: 17 Rockdale Avenue
Salem, MA 01970
Policy Number: HP236640
Date of Loss: 03/02/2018
Cause of Loss: Wind
LA File Number: MA-2-34668
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.
Robert Siscoe
Adjuster
LaMarche Associates,Inc.-800-149-1525
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