30 Crowdis Street 10-27-18 claim LaMarche Associates
5 North Road, P.O. Box 250
Chelmsford, MA 01824
800-349-1525
Fax: 978-256-8590
October 30, 2018
RECEIVED
Building Commissioner/Inspector of Buildings NOV 13 2018
Salem, MA 01970-1945
CITY OF SALEM
Board of Health/Board of Selectmen BOARD OF HEALTH
Salem, MA 01970-1945
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 Cha ter
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: Solange Miller
Loss Location: 30 Crowdis Street
Salem, MA 01970-1945
Policy Number: 2003686544
Date of Loss: 10/27/2018
Cause of Loss: Wind
LA File Number: MA-2-35686
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.
John Dunphy
Adjuster
LaMarche Associates,Inc.-800-349-1525
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