30 CHURCH STREET - CLAIM NOTICE 0_-00�q� Samuel F. McCormack Co. Inc.
Insurance Adjusters and Appraisers
Samuel F.McCormack Co.,Inc.
ADJUSTERS AND APPRAISERS
July 2, 2021
Salem City Hall
Building Inspector
93 Washington Street
Salem. MA 01970
RE ASSURED: Mass Bay Colony Properties LLC ATTN: Scott Perry
LOSS LOCATION: 30 Church St, Salem, MA 01970
POLICY NO: BOPO 149678
TYPE OF LOSS: Water
DATE OF LOSS: 06/30/2021
OUR FILE NO: 21-01600
To Whom It May Concern:
Claim has been made involving loss, damage or destruction of the above-captioned property, which
may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 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 this writer and include a reference to the above-
captioned insured, location, policy number, date of loss and claim or file number.
Thank you for your anticipated cooperation.
Very truly yours,
Edward Bennett
Adjuster
efb@mccormackadjuster.com
cc: Board of Health
Fire Department
JUL
42 Holbrook Avenue, Braintree, MA 021841-800-972-5399(781)843-1222 Fax(781)849-8191
125 Waterhouse Road, Bourne, MA 02532(508)403-2600 Fax(508)403-2602
www.niecormackadjuster.com