54 Market St. Insurance Loss 2021Safety Insurance
AUTO • HOME • BUSINESS
Building Commissioner or Inspector of Buildings
Fire Department or Arson Squad
Board of Health or Board of Selectmen
City Hall
NORTHAMPTON, MA 01060
RE: Claim Number:
Insured(s):
Property Address:
Policy Number:
Date of Loss:
September 13, 2021
LHMA001 CE2
MARIA PERET
54 MARKET ST, NORTHAMPTON, MA 01060
H MA0441550
9/6/2021
Notice of Loss Under M.G.L. c. 139. 4 3113
This communication shall serve as written notice pursuant to M.G.L. c. 139, § 3B that [Safety
Insurance Company] ("Safety") has received a claim involving loss, damage or destruction to a
building or other structure at the above -reference address which may either: (1) meet or exceed
$1,000; or (2) cause the condition or the building or other structure to render M.G.L. c. 143 § 6
applicable.
In accordance with M.G.L. c. 139, § 313, if the city or town intends to initiate proceedings designed
to perfect a lien under Section 313, M.G.L. c. 143, §9 or M.G.L. c. 111, § 127B, please notify Safety
of the same by certified mail. Kindly forward such notice to my attention, at the address indicated
above, and include with such notice a reference to the above-described insured, property address,
policy number and claim number.
If you have any questions regarding this notice, please feel free to contact me directly by email at
chrisrivera@safetyinsurance.com or by phone at 6179510600.
Sincerely,
Christopher Rivera
Associate Property Field Adjuster
Visit us at www.safetyinsurance.com/claims for Frequently Asked Claims Questions
Safety Insurance P.O. Box 55098 Boston, MA 02205-5098 800-951-2100
Wel! help you manage life's storms® El n ® 0 010 C139