80 ALMEDA STREET - BUILDING JACKET UPC 10330
No. 153L 1121
HASTINGS. NN
BUTTERWORTH & O'TOOLE, INC.
PO. BOX 8294
SALEM, MA 01971-8294
ADJUSTERS/APPRAISERS -
FOR INSURANCE COMPANIES ONLY
TELEPHONE (978)741-5731 FAX (978)740-9109
September 08 , 1999.
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
TO: Building Commissioner or Board of Health or
Inspector of Buildings Board of Selectmen
City/Town Hall City/Town Hall
ADDRESSES
Salem, MA 01970 Salem, MA 01970
RE: Insured: Frances Garrow
Address : 80 Almeda Street
Salem, MA 01970
Policy No. : HP1814374
Loss of : 9/6/99
File or Claim No. : 97-1059
Claim has been made involving loss, damage or destruction of the
above captioned property, which may either exceed $1, 000 . 00 or cause
Mass. Gen. Laws, Chapter 143, Section 6 to be applicable . If any notice
under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct it
to the attention of the writer and include a reference to the captioned
insured, location, policy number, date of loss and claim or file number.
If no reply is received from your office within ten days, we will
assume you have no liens of any type against this property and we will
recommend to the insuring company that this claim is paid.
James Ranta
Adjuster