43 Station Road 11-28-18 claim Michael Winston & Associates, LLC
Innovative Risk Specialists DEC 0 4"1M
POB 287
CITY OF 3ALEM
Salem,NH 03079 00"'A D OF HEf\D' 1
�--" Tel: 603-494-2366 - Fax: 888-306-8106 - E-mail: michaelwinston@comcast.net
November 29,2018
Building Commissioner/Building Inspector
Board of Selectman/Board of Health
93 Washington Street
Salem, MA 01970
RE: Jeffrey& Karyn Smith
43 Station Road
Salem, MA 01970
Type of Loss: Water
Date of Loss:November 28,2018
Policy: HO17049790
Claim number: H0013004
Our File#: MW 18-274 Location of Loss: Same
To whom it may concern:
The above captioned claim has been made involving damages or destruction of property which may exceed
$1,000.00 or cause Massachusetts General Laws, Chapter 143,Section 6 to be applicable. If any notice
under Massachusetts General Laws, Chapter 139B is appropriate,please direct it to the attention of the
undersigned and include a reference to the captioned insured, location,policy number,date of loss,cause of
loss and claim or file number.
On this date, I caused copies of this notice to be sent to the persons named above at the addresses indicated
above via first class mail.
Sincerely,
Michael Winston
Adj uster