23 PHELPS STREET 11-19-18 CLAIM RECEIVED LaMarche Associates
5 North Road, P.O. Box 250
DEC 2 02018 Chelmsford, MA 01824
O HEAL
F HEALTH
800-349-1525
BOARD O
CITY Fax: 978-256-8590
November 21, 2018
Building Commissioner/Inspector of Buildings
Salem, MA 01970-3018
Board of Health/Board of Selectmen
Salem, MA 01970-3018
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 313 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: Roger Pied
Loss Location: 23 Phelps Street
Salem, MA 01970-3018
Policy Number: 2006814790
Date of Loss: 11/19/2018
Cause of Loss: Wind
LA File Number: MA-2-35783
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
Adjuster
LaMarche Associates,Inc.-900-349-1525
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