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51-53 Ocean Avenue 10-16-19 claim RECEIVED LaMarche Associates OCT 2019 5 North Road, P.O. Box 250 Chelmsford, MA 01824 CITY OF SALEM 800-349-1525 BOARD OF HEALTH Fax: 978-256-8590 October 17, 2019 Building Commissioner/Inspector of Buildings Salem, MA 01970-5465 Board of Health/Board of Selectmen Salem, MA 01970-5465 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 36 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: Michael & Elizabeth Hinchion Loss Location: 51-53 Ocean Avenue Salem, MA 01970-5465 Policy Number: DP00011852 Date of Loss: 10/16/2019 Cause of Loss: Wind LA File Number: MA-2-37117 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. Kris Kirkpatrick Adjuster LaMarche Associates,Inc.-800-349-1525 Page i of 1