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7 Hamilton Street 6-11-21 claim Agllh Ir"Mr Safety Insurance,,, RECEIVED AUTO•HOME.BUSINESS JUN 21 2021 CITY OF SALEM BOARD OF HEALTH June 16, 2021 Building Commissioner or Inspector of Buildings Fire Department or Arson Squad Board of Health or Board of Selectmen City Hall SALEM, MA 01970 RE: Claim Number: LHMA0015BA Insured(s): JOYCELYN J. SNELL Property Address: 7 HAMILTON STREET UNIT #3, SALEM, MA 01970 Policy Number: HMA0349352 Date of Loss: June 11, 2021 Notice of Loss Under M.G.L. c. 139A 3113 This communication shall serve as written notice pursuant to M.G.L. c. 139, § 313 that [Safety Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a building or other structure at the above-reference address which may either: (1) meet or exceed $1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143 § 6 applicable. In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to perfect a lien under Section 3B, M.G.L. c. 143, §9 or M.G.L. c. 111, § 127B, please notify Safety of the same by certified mail. Kindly forward such notice to my attention, at the address indicated above, and include with such notice a reference to the above-described insured, property address, policy number and claim number. If you have any questions regarding this notice, please feel free to contact me directly by email at LisaMonette@Safetylnsurance.com or by phone at 800-951-2100 x3420. Sincerely, Lisa Monette Property Claims Field Adjuster Safety Insurance P.O. Box 55098 Boston, MA 02205-5098 800-951-2100 We'll help you manage life's sformsO 0 F1 ® :,A 010 c1s9