10 12 Geneva Street- Claim Notice Samuel F. McCormack Co., Inc.
Insurance Adjusters and Appraisers
58muel F.McCormack Ca.,Ine.
ADJUSTERS AND APPUIRRS
May 10, 2022
Salem City Hall
Building Inspector
93 Washington Street
Salem, MA 01970
RE ASSURED: 12 Geneva St Condominium, c/o Jean Paulynice
LOSS LOCATION: 10-12 Geneva St, Salem, MA 01970
POLICY NO: BP28021978
TYPE OF LOSS: Fire
DATE OF LOSS: 05/09/2022
OUR FILE NO: 22-01263
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 3B 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,
A� 14e�-U_
Peter Venie
Adjuster
pv@mccormackadjuster.com
cc: Board of Health
Fire Department
42 Holbrook Avenue, Braintree, MA 02184 1-800-972-5399(781)843-1222 Fax(781)849-8191
125 Waterhouse Road, Bourne,MA 02532(508)403-2600 Fax(508)403-2602
www.mccormackadjuster.com