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Insurance Claims FRIEDLINE&CARTER ADJUSTMENT, INC. 436 Main Street, P. O. Box 338 Hyannis, Massachusetts 02601 Tel. (508) 771-3232 FAX (508) 790-2344 TO: ( Building Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectmen ( ) Fire Department TOWN OF YARMOUTH TOWN HALL YARMOUTH, MA RE: Insured: BLINN, Allyson L& CONTI, Nicholas J II Property Address: 55 North Road West Yarmouth, MA 02673 Policy Number: BA180077130524 Type of Loss: Septic Date of Loss: 6/12/2019 File#: 131497 Claim has been made involving loss, damage or destruction of the above captioned property,which may either exceed $1,000.00 or cause Mass. General Laws, Chapter 143, Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate, please direct it to the attention of this writer and include a reference to the captioned insured, location, policy number, date of loss and file number. 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. J. COHEN Adjuster 6/17/2019