97 BOSTON STREET 4-1-18 CLAIM RECEIVED LaMarche Associates
5 North Road, P.O. Box 250
MAY 0 3 2018 Chelmsford, MA 01824
800-349-1525
CITY OF SALEM Fax: 978-256-8590
BOARD OF HEALTH
April 17, 2018
Building Commissioner/Inspector of Buildings
SA;LEM, MA 01970
Board of Health/Board of Selectmen
SA;LEM, MA 01970
NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139 SECTION 38
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
Chanter 143, Section 6 to be applicable. If any notice under Massachusetts General Laws
Chaoter 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: THANH PHI LONG
Loss Location: 97 BOSTON STREET
SA;LEM, MA 01970
Policy Number: BO203348
Date of Loss: 04/O1/2018
Cause of Loss: Water
LA File Number: MA-2-34888
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.
John Anderson
Adjuster
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Lamarche Associates,IM.-800-349-1525
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