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Home My WebLink AboutNotice of Loss 122722 GEICO Insurance Agency, LLC Underwritten By: Homesite Homesite Indemnity Company Tel: 1 800 566 1518 HOME INSURANCE Fax: 1-866-935-2858 6000 American Parkway Madison,WI 53783-0001 66259002 NN RP 29 20221229 NNNNNNNN 0001189 0006 Claim Number: 01-005-604081 YARMOUTH TOWN CLERK'S OFFICE Date Of Loss: 12/27/2022 1146 ROUTE 28 Policy Number: 38819385 SOUTH YARMOUTH, MA 02664-4463 Policyholder: James Sullivan IIII��II�IIII��II� �IIiiIIi111111111111IIIIIu1111/1111111I'I'III December 28 2022 fig 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: JAMES SULLIVAN Property Address: 6 Nimble Hill Dr Yarmouth Port, MA, 02675-2189 Policy Number: 38819385 Claim Number: 01-005-604081 Date of Loss 12/27/2022 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, Hector Fuertes Claim Bilingual Adjuster II AFICS on behalf of Homesite Indemnity Company Hector.Fuertes@afics.com RECEIVED Phone: 1-608-722-3421 I Fax: 1-866-935-2858 Mail: 6000 American Parkway, Madison, WI 53783-0001 LAN 04 2023 BUILDING DEPARTMENT By' Page 1 of 1 68259002IIN RP S 20221279 NNNNNNNN 0001169 0306 80e758a1u�65-41e5-B04b3b724b4767P Pegs 1 012