47 Lafayette Street 10-17-19 claim RECEIVED LaMarche Associates
5 North Road, P.O. Box 250
DEC 2 02019 Chelmsford, MA 01824
800-349-1525
CITY OF SALEM Fax: 978-256-8590
BOARD OF HEALTH
December 16, 2019
Building Commissioner/Inspector of Buildings
Salem, MA 01970
Board of Health/Board of Selectmen
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: North Shore CDC
Loss Location: 47 Lafayette Street
Salem, MA 01970
Policy Number: BP21053609
Date of Loss: 10/17/2019
Cause of Loss: Fire
LA File Number: MA-2-37392
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.
David Valley
Adjuster
LaMarche Assoclates,Inc.-800-349-1525
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