HomeMy WebLinkAboutClaim of Loss -12/3/2018 W.Springfield, MAS r, T aPittsfield,MA
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Building Commissioner or Board of He th or
Inspector of Buildings Board of S ectmen
Town of Yarmouth Town of armouth
1146 Route 28 1146 ute 28
South Yarmouth, MA 02664 Sout armouth, MA 02664
Attention: Records Atte tion: Records
COMPANY: Certain Underwriters at Lloyd's, London c/o Quaker Special Risk
POLICY NUMBER: QSRMA12626
CLAIM NUMBER:
INSURED: S &N Realty Trust
LOSS LOCATION: 657 Route 28, Yarmouth, C e CiL5
DATE OF LOSS: 11/24/2018DESCRIPTION: Water 018OUR FILE NUMBER: CCI18-7099
B
By�__G DEPARTegA
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, or cause Massachusetts General Law, Chapter 143, Section 6, to be
applicable. If any notice under Massachusetts General Law, Chapter 139, Section 3B, is appropriate,
please direct it to the attention of this writer and include a reference to the captioned insured,
location,policy number, company claim number, date of loss,and claim or file number.
Sincerely,
Ed Dibona -
Claims Adjuster
P—508-758-6633
F—508-758-6199
ed@georgebutleradjusters.com
On this date, I caused copies of this notice to be sent to the persons named above at the address
indicated above, by first class mail.
Secretary
November 27, 2018
209 Park Avenue, West Springfield,MA 01089