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66 Essex Street 4-28-20 claim LaMarche Associates 5 North Road, P.O. Box 250 Chelmsford, MA 01824 800-349-1525 Fax: 978-256-8590 April 28, 2020 Building Commissioner/Inspector of Buildings RECEIVED Salem, MA 01970 MAY 01 2020 Board of Health/Board of Selectmen CITY OF SALEM Salem, MA 01970 BOARD'OF HEALTH 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: Bryan Fink Loss Location: 66 Essex Street, Unit 1 Salem, MA 01970 Policy Number: 2008232807 Date of Loss: 04/28/2020 Cause of Loss: Water LA File Number: MA-2-37885 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. Tony Rossetti Adjuster LaMarche Associates,Inc.-800-349-1525 Page 1 of 1