HomeMy WebLinkAboutNotice of Loss 080322 THENORFOLIDEDHAMGROUP®
Norfolk& Dedham Mutual Fire Insurance Co. Dorchester Mutual Insurance Co. Fitchburg Mutual Insurance Co.
August 5, 2022
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.: P2200638
Insured: VICTORIA CIOBANU
ANDREI CIOBANU
Address: 19 NIGHTINGALE DRIVE, SOUTH YARMOUTH, MA
Policy No.: H1667811A
Loss Date: 08/03/2022
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 anal claim or fi!c 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 0 8 2022
Laurie A Fernandes BUILDING DEPARTMENT
BY -----
Senior Property Claims Examiner
1-800-688-1825 x1238
Home Office Mid-Atlantic
222 Ames Street,P.O.Box 9109 Iktr3 50 Division Street,Suite 400
Dedham,MA 02027-9109 SINCE 1825 Somerville,NJ 08876
Phone:(800)688.1825 www.ndgroup.com