421 Loss to Building Letter 2016 LaMarche Associates
1482 North Main Street, P.O. Box 840
Palmer, MA 01069
800-222-0143
Fax: 413-289-1249
February 17, 2016
Building Commissioner/Inspector of Buildings
Leeds, MA 01053
Board of Health/Board of Selectmen
Leeds, MA 01053
NOTICE OF CASUALTY LOSS TO BUILDING
UNDER MASSACHUSETTS GENERAL LAWS CHAPTER 139. SECTION 3B
Claim has been made involving loss, damage or destruction of the property captioned below, 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 a reference to the captioned insured,
location, policy number, date of loss, cause of loss and LA file number.
Insured: Soldier On Inc Soldier On Development Co Inc.
Loss Location: 421 North Main Street
Leeds, MA 01053
Policy Number: PHPK1337458
Date of Loss• 02/15/2016
Cause of Loss: Water
LA File Number: MA-1-25454
On this date, I caused copies of this notice to be sent to the persons named above at the addresses
indicated above by first class mail.
John Murray
Adjuster