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9-11 LUSSIER STREET 8-9-22 CLAIMLaMarche Associates 5 North Road, P.O. Box 250 Chelmsford, MA 01824 800-349-1525 Fax: 978-256-8590 August 10, 2022 Building Commissioner/Inspector of Buildings Salem, MA 01970-4524 Fire Department/Arson Squad Salem, MA 01970-4524 Board of Health/Board of Selectmen Salem, MA 01970-4524 NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASSACHUSETTS GENERAL LAWS, CHAPTER 139, SECTION 3B Claim has been made involving loss, damage or destruction of the property captioned below, 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, policy number, date of loss, cause of loss and LA file number. Insured:Lorraine Beauregard Loss Location:9-11 Lussier Street Salem, MA 01970-4524 Policy Number:HP00012923 Date of Loss:08/09/2022 Cause of Loss:Physical Damage LA File Number:MA-2-41341 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. Kevin Gabbett Adjuster LaMarche Associates, Inc. - 800-349-1525Page 1 of 1