HomeMy WebLinkAboutClaim of Loss THENORFOLIWDEDHAMGROUP®
August 24, 2018
FORM OF NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASS. GEN. LAWS, CH. 139, SEC. 3B
Building Commissioner, or Inspector of Buildings
do City or Town Hall
1146 Route 28
South Yarmouth, MA 02664
Board of Health or Board of Selectmen
do City or Town Hall
1146 Route 28
South Yarmouth, MA 02664
Fire Department or Arson Squad
do City or Town Hall
1146 Route 28
South Yarmouth, MA 02664
RE: Our File No.: P1844956
Insured: JANET MELANSON
Address: 203 GREAT WESTERN ROAD, SOUTH YARMOUTH, MA
Policy No.: N0623042
Loss Date: 08/22/2018
Loss Type: Building or Other Structure Damage
A 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, Ch. 143, Sec. 6 to be
applicable. If any notice under Mass. Gen. Laws, Ch. 139, Sec. 3B is appropriate, please direct
it to my attention and include a reference to the captioned insured, location, policy number, loss
date 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 the claim will be paid in our customary manner.
Sincerely,
RECEIVED
AUG 27 2018
William Lamb BUILDING DEPARTMENT
Manager, Property Claims oY
1-800-688-1825 x1137
NORFOLK&DEDHAM MUTUAL FIRE INSURANCE CO. 222 Ames Street,P.O.Box 9109,Dedham,MA 02027-9109
DORCHESTER MUTUAL INSURANCE CO. JJ Telephone:(800)688-1825
FITCHBURG MUTUAL INSURANCE CO. l9 ® Fax:(781)329-1818