183 North Street 1-19-20 claim RECEIVE® LaMarche Associates
5 North Road, P.O. Box 250
JAN 2 8 2020 Chelmsford, MA 01824
800-349-1525
CITY OF SALEM Fax: 978-256-8590
BOARD OF HEALTH
January 22, 2020
Building Commissioner/Inspector of Buildings
Salem, MA 01970-1601
Board of Health/Board of Selectmen
Salem, MA 01970-1601
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, Chaster
143, Section 6 to be applicable. If any notice under Massachusetts General Laws Chapter
139. Section 313 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: Thomas & Kate Casey
Loss Location: 183 North Street
Salem, MA 01970-1601
Policy Number: H012356498
Date of Loss: 01/19/2020
Cause of Loss: Water
LA File Number: MA-2-37518
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.
David Valley
Adjuster
LaMarche Associates,Inc.-800-349-1525
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