296 Washington Street 6-27-18 claim RECEIVE® LaMarche Associates
5 North Road, P,O. Box 250
Chelmsford, MA 01824
JUL 12 2913 800-349-1525
CITY OF SALEM Fax: 978-256-8590
BOARD OF HEALTH June 28, 2018
Building Commissioner/Inspector of Buildings
Salem, MA 01970
Board of Health/Board of Selectmen
Salem, MA 01970
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 3B 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: H L Realty Trust
Loss Location: 296 Washington Street
Salem, MA 01970
Policy Number: BP21049941
Date of Loss: 06/27/2018
Cause of Loss: Fire
LA File Number: MA-2-35188
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 MSOdatca,Inc.-800-09-1525
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