HomeMy WebLinkAboutNotice of Loss 91122 CLAIM DEPARTMENT
101 HIGH STREET, P. O. BOX 40, NORWICH, CT 06360
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(860)887-3553—CT 1-800-962-0800—MA-RI 1-800-243-4080-FAX(860)886-8270-www.nlansurance.com
September 22, 2022
RECEiv
Inspector of Buildings
1146 Rt. 28 SFP 6 2022
Yarmouth, MA 02664 a UrFpiN �T
_._G��A MENT
SUBJECT: Insured: Ann L Fontaine
Property Address: 30 Skyline Drive, West Yarmouth, MA 02673
Policy Number: 15033216H0
Date of Loss: 09/11/22
Claim Number: 22H1001603
To Whom It May Concern:
A claim has been made involving loss, damage, or destruction of the above captioned property, 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 reference to the captioned insured, location,
policy number, date of loss, and claim number.
On this date, copies of this notice have been sent by first class mail to the municipal officials for the
property address listed above.
Sincerely,
eA.Je- c7e ci)u
Steve L. Lubanski 1Arr
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