51 Lafayette Street 10-5-18 claim RECEIVED
OCT 15 2018 LaMarche Associates
5 North Road, P.O. Box 250
CITY OF SALEM Chelmsford, MA 01824
BOARD OF HEALTH 800-349-1525
Fax: 978-256-8590
October 9, 2018
Building Commissioner/Inspector of Buildings
Salem, MA 01970-7500
Board of Health/Board of Selectmen
Salem, MA 01970-7500
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: Ramsey Hasan
Loss Location: 51 Lafayette Street
Salem, MA 01970-7500
Policy Number: H012388636
Date of Loss: 10/05/2018
Cause of Loss: Water
LA File Number: MA-2-35577
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.
Kevin Gabbett
Adjuster
LaMarche Associates,Inc.-800-349-1525
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