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Home My WebLink AboutNotice of Loss 113023 Progressive Home, by Homesite ■ p�®L7lILJ/vE Underwritten By: HOME 1 O P : Homesite Insurance Company Tel: 1-866-960-8609 Fax: 1-866-935-2858 6000 American Parkway Madison,WI 53783-0001 66259002 NN RP 02 20231202 NNNNNNNN 0008881 0028 Claim Number: 01-006-980679 TOWN OF YARMOUTH - BUILDING DEPARTMENT Date Of Loss: 11/30/2023 1146 ROUTE 28 Policy Number: 40135916 SOUTH YARMOUTH, MA 02664-4463 Policyholder: Conrad Alexander Herrmann And Madison Taylor Herrmann 1111111111111111111111111111111.1111 I I I'I' December 2, 2023 ATTENTION: Building Commissioner or Inspector of Buildings Fire Department or Arson Squad, Board of Health or Board of Selectmen C/O City or Town Hall NOTICE PURSUANT TO MASS. GEN. LAWS, CHAPTER 139, SECTION 3B Our Insured: CONRAD ALEXANDER HERRMANN Property Address: 89 N Dennis Rd South Yarmouth, MA, 02664-1017 Policy Number: 40135916 Claim Number: 01-006-980679 Date of Loss 11/30/2023 This correspondence shall serve as notice that, pursuant to Massachusetts General Laws Chapter 139, Section 3B, a claim has been made involving loss, damage or destruction to a building or other structure which may either exceed$1,000 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If any notice pursuant to Massachusetts General Laws Chapter 139, Section 3B is appropriate, please direct such notice to my attention and kindly, pursuant to the information provided above, include the insured's name, address, policy number, claim number and date of loss. If you contact us via email, please use claimdocuments@afics.com and be sure to reference the claim number in the subject line of your email. Please contact me with any questions. Sincerely, 7747/frerd4 M)66450 Thomas Wuelper Claim Adjuster II AFICS on behalf of Homesite Insurance Company Thomas.Wuelper@afics.com Phone: 1-857-248-8047 I Fax: 1-866-935-2858 Mail: 6000 American Parkway, Madison, WI 53783-0001 RECEIVED DEC 0 8 2023 BUILDING DEPARTMENT By. — - Page 1 of 1 66259002 NN RP 02 20231202 NNNNNNNN 0008881 0028