268 Washington Street 5-14-20 claim W.Springfield, MAGeorge Pittsfield, MA
(413)781-2897 (888)881-4598
Quincy, MA Butler Worcester,MA
(617)479-2619 (888)881-4598
Mattapoisett, MA �a i usters Cape Cod&Islands
(508)758-6633 (888)881-4598
Rhode Island Inc. Hartford, CT
(888)881-4598 BUTLER (888)881-4598
Building Commissioner or RECEIVED Board of Health or
Inspector of Bdildings Board of Selectmen
City of Salem MAY 2 6 Z0Z0 City of Salem
120 W slimgton Street 120 Washington Street
3rd F 1ior CITY OF SALEM 4th Floor
501 , MA 01970 BOARD OF HEALTH Salem, MA 01970
Attention: Records Attention: Records
COMPANY: Certain Underwriters at Lloyds, London c/o Vanguard Claims
Administration, Inc.
POLICY NUMBER: XSZ137897
CLAIM NUMBER: XS07868
INSURED: Major Mageleash's Felicia's RT dba Major Magleashes
LOSS LOCATION: 268 Washington Street, Salem, MA
DATE OF LOSS: 05/14/2020
DESCRIPTION: Water
OUR FILE NUMBER: P20-10597
To Whom It May Concern:
Claim has been made involving loss, damage, or destruction of the above captioned property which
may either exceed $1,000, or cause Massachusetts General Law, Chapter 143, Section 6, to be
applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B, is appropriate,
please direct it to the attention of this writer and include a reference to the captioned insured,
location,policy number, company claim number, date of loss, and claim or file number.
Sincerely,
John Schillizzi
Claims Adjuster
P—(978) 818-5453
F—617-470-1740
JohnS@georgebutleradjusters.com
On this date, I caused copies of this notice to be sent to the persons named above at the address
indicated above,by first class mail.
Secretary
May 19, 2020
P.O.Box 1557,Mattapoisett,MA 02739