85 Federal Street 6-4-18 claim RE-CEIVE_D
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Safety Insurance JUN 2 5 2018
AUTO •HOME .BUSINESS CITY OF SALEM
P.O. Box 55098 BOARD OF HEALTH
Boston MA 02205
617-951-0600
June 19, 2018
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectman
City Hall
SALEM, MA 01970
Insured: FRANCIS J MURPHY and DBA MURPHY FUNERAL HOME
Property Address: 85 FEDERAL ST, SALEM MA
Policy Number: BMA0023927
Claim Number: BOS00085506
Date of Loss: 6/4/2018
Notice of Loss Under M.G.L. c. 139,�3B
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that[Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above-referenced address which may either: (1) meet or exceed
$1,000; or(2) cause the condition or the building or other structure to render M.G.L. c. 143, §6
applicable.
In accordance with M.G.L. c. 139, § 3B, if the city or town intends to initiate proceedings designed
to perfect a lien under Section 3B, M.G.L. c. 143, § 9 or M.G.L. c. 111, § 127B, please notify
Safety of the same by certified mail. Kindly forward such notice to my attention, at the address
indicated above, and include with such notice a reference to the above-described insured, property
address, policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly at
617-951-0600 EXT 3461.
Sincerely,
Jeff Edwards
Claim Examiner