HomeMy WebLinkAboutNotice of Loss 100521 1ti 1)L1NE
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TO: Yarmouth Building Department
1146 Route 28
South Yarmouth, MA 02664
E ENV " D
RE: Insured: Karen Kuhn Antonio
Policy Number: ATR/D/46234.05 sEp 2 3 2022 I s
Type of Loss: Tenant Damage BUILDING DEPARTM. ENT
Date of Loss: 10-05-2021 By.
Property Address: 15 Tam-O-Shanter Way
South Yarmouth, MA 02764
File#: XFUAQ21102
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 entity named above at the
address indicated above by First Class Mail.
Brett Valentini
Adjuster
09-21-2022
P.O.Box 309,915 Route 6A,Yarmouth Port,MA 02675-0309 I Phone:(508)771-3232 I Fax:(508)790-2344
claims@friedlineandcarter.corn