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296 Insurance Loss 12-2020LaMarche Associates 1482 North Main Street, P.O. Box 840 Palmer, MA 01069 800-222-0143 Fax: 413-289-1249 December 17, 2020 Building Commissioner/Inspector of Buildings Florence, MA 01062-9780 Board of Health/Board of Selectmen Florence, MA 01062-9780 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:Kimberly Arra & Adam Lesko Loss Location:296 Sylvester Road Florence, MA 01062-9780 Policy Number:PH00100954799 Date of Loss:12/17/2020 Cause of Loss:Ice and Snow LA File Number:MA-1-28297 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. Timothy Kendrick Adjuster LaMarche Associates, Inc. - 800-222-0143Page 1 of 1