96 LINDEN STREET - CLAIM NOTICE Wo�=" Safety Insurance
AUrO. HOME•BUSINESS
July 9, 2021
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectmen
City Hall
SALEM, MA 01970
RE: Claim Number: LHMA001745
Insured(s): HUE T NGUYEN
Property Address: 96 LINDEN STREET, SALEM, MA 01970
Policy Number: HMA0481512
Date of Loss: July 6, 2021
Notice of Loss Under M.G.L. c. 139, § 3B
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above-reference address which may either: (1) meet or exceed
$1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143 § 6
applicable.
In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed to
perfect a lien under Section 313, M.G.L. c. 143, §9 or M.G.L. c. 111, § 127B, please notify Safety of
the same by certified mail. Kindly forward such notice to my attention, at the address indicated
above, and include with such notice a reference to the above-described insured, property address,
policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly by email at
JessicaTuccelli@Safetylnsurance.com or by phone at 800-951-2100 x5194.
Sincerely,
Jessica Tuccelli
MultiLines PD Claims Adjuster
JAIL 15 rm2:32
Safety Insurance P.O. Box 55098 Boston, MA 02205-5098 800-951-2100 JUL
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