CLAIM LOSS - 11/4/2021 VERMONTMUTUAL VERMONT MUTUAL INSURANCE COMPANY
NORTHERN SECURITY INSURANCE COMPANY, INC.
® INSURANCE GROUP GRANITE MUTUAL INSURANCE COMPANY
SINCE 1828
October 29, 2021
Board of Health
Town of Salem
98 Washington St
Salem, MA 01970-4323
NOTICE OF CASUALTY LOSS UNDER MASSACHUSETTS
GENERAL LAWS, CHAPTER 139, SECTION 313
Insured: David Sweet
Claim Number: H0032450
Policy Number: H017114809
Date of Loss: 10/27/21
Property Location: Stephanie Mitchell, 11 Hayes Road, Salem, MA 01970-4323
Type of Loss: Tree Fell On Fence And Lawn Furniture
Ladies and Gentlemen:
A claim has been made involving loss, damage or destruction of the above-captioned property
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, locations, policy number, date of loss and claim or file number.
Thank you for your cooperation.
Sincerely,
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Cannon Blanchard
Associate Claim Representative
Extension: 8391
cfblanchar@vermontmutual.com
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STABLE PREDICTABLE COMPETENT PARTNER
89 State Street, PO Box 188,Montpelier, VT 05601-0188 1 800.451.5000 1 vermontmutual.com