200 JEFFERSON AVENUE 4-11-22 CLAIM131 Dodge Street, Suite 6
Beverly MA, 01915
Phone (978) 927-3000 Fax (978) 927-3002
Email: info@newenglandclaims.com
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
To: Inspector of Buildings
Salem, MA
RE:
Insured: 200 Jefferson Avenue Condo
Property Address: 200 Jefferson Ave
Cause of Loss: Property
Date: 04/11/2022
File/Claim No.: NECS5413
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, location, police number, date of loss and claim or file number.
Section 3B. No insurer shall pay any claims (1) covering the loss, damage or destruction to a building or other structure,
amounting to one thousand dollars or more, or (2) covering any loss, damage or destruction of any amount, which
causes the condition of a building or other structure to render section six of chapter one hundred and forty-three
applicable, without having at least ten days previously given written notice to the building commissioner or inspector of
buildings appointed pursuant to the state building code, to the fire department or arson squad of the city of town and to
the board of health or board of selectmen of the city or town in which the same is located. If at any time prior to
payment the said city or town notifies the insurer by certified mail of its intent to initiate proceedings designed to
perfect a lien pursuant to section three A, or to section nine of chapter one hundred and forty-three, or section one
hundred and twenty-seven B of chapter one hundred and eleven, the said payment shall not be made while the said
proceedings are pending; provided, however, that said proceedings are initiated within thirty days of receipt of such
notification.
Any lien perfected pursuant to section three A, or to section nine of chapter one hundred and forty-three or section one
hundred and twenty seven B of chapter one hundred and eleven, shall extend to and may be enforced by the city or
town against any casualty insurance policy or policies covering any loss, damage or destruction pursuant to which the
proceeds to perfect the lien were initiated.
No insurer shall be liable to any insured owner, mortgagee, assignee, city or town, or other interested party for amounts
disbursed to a city or town under the provisions of this section, or for amounts not disbursed to a city or town under the
provisions of this section.
On this date, I caused copies of this Notice to be sent to the persons named above at the addresses indicated above by
First Class Mail.
Very truly yours,
New England Claims Service
978-927-3000
info@newenglandclaims.com
www.newenglandclaims.com
cc:Salem Fire Department
Salem, MA
Board of Health
Salem, MA