2 ARTHUR STREET - CLAIM NOTICE ���N���
" " `^-°��~~R° O=~° DEDwmAMG^^OU^ A,
Modb|k& Dedham Mutual Fire Insurance Co. Dorchester Mutual Insurance Co. Fitchburg Mutual Insurance Co.
January 7. 2022
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
Building Commissioner, Or Inspector ofBuildings
c/o City orTown Hall
Q3 Washington St.
Salem, MA 01970
Board of Health or Board of Selectmen
{/o City or Town Hall
S3 Washington St.
Salem, MA 01970
Fire Department or Arson Squad
c/o City or Town Ma||
93 Washington St.
Salem, MA 01970
RE: Our File No.: P2190057
Insured: DAN|ELLEBLANC
Address: 2 /\RTHUR0T. SALEM. MA
Policy No.: [}1972204A
Loss Date: 11/07/2021
Loss Type: Building mr Other Structure Damage
/\ C|8imn has been made involving |oSm, damage or destruction of the above captioned ppopertv,
which may either exceed $1.000.00 or cause yWome. Gen. Lam0, Ch. 143, Sec. 8 to be
applicable. If any notice under yWmea. Gen. Laws, Ch. 139, Sec. 3B is appropriabd' okaa8G direct
it to my attention and include a reference 1othe captioned insured, location, po|icy,number, |mma
doby and claim or file number.
If no reply is received from your office within ten doys, we will assume you have no liens of any
type against this prOperty, and the claim will be paid in our customary manner-
Sincerely,
JAN ��
JA!,�
Kathleen Coelho
Supervisor, Property Claims
1-800-888-1825x1251
Home Office Mid-Atlantic
zzc Ames Street,p.o.Bovo1oo hD 5o Division Street,Suite 4on
Dedham,�x o�nur's�oo Somerville,wJoum7o
SINCE '
Phone:(non)O88.1V2a wwwnu0raup.nom