12 CABOT STREET 1-26-22 CLAIM RECEIVED
INDEPENDENT APR 262022
CLAIMS SERVICE, INC. CITY OFSALEM
BOARD OF HEALTH
Service • Integrity - Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139,Section 3B
April 22,2022
Salem,MA Building Inspector
1 Salem Green
Salem, MA 01970
Salem,MA Board of Health
9 North. Street
Salem, MA 01970
Salem,MA Fire Department
48 Lafayette Street
Salem,MA 01970
INSURED: Michael Farias
ADDRESS: 12 Cabot St, Salem,MA 01970-4850
LOCATION OF LOSS: 12 Cabot St, Salem,MA 01970-4850,US
COMPANY: MAPFRE Insurance
POLICY#: 4987566487
CLAIM#: 22-91370
DATE OF LOSS: 01/26/2022
TYPE OF LOSS: Vehicle
Dear Sir or Madam:
Independent Claims Service is the insurance adjusting firm hired by the above referenced client to handle the
captioned loss on behalf of their insured.
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
notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please bring it to our
attention, and include a reference of the captioned insured: Location,policy number, and/or date of loss.
Sincerely,
INDEPENDENT CLAIMS SERVICE,INC.
22 Water Street • Westborough,MA 01 581 • 508.366.8535 • FAX 508.366.091 7 • www.icsclaims.com