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Insurance Claim 7;,/ FRIEDLINE, CARTER & JOHNSON ADJUSTMENT 1 Welby Road, P .O. Box 50128 New Bedford, MA 02745-0005 `ice Tel . ( 508 ) 998-2113 Fax. ( 508 ) 998-2136 SJ I�.w L.i AP 11 1 i TO: ( ) Building Commissioner or Inspector of Buildings ( ) Board of Health or Board of Selectman ( ) Fire Department TOWN OF DARTMOUTH TOWN HAT,T, DARTMOUTH, MA RE: Insured: ROGERS, WALTER & ALICE Property Address : 115 PINE ISLAND ROAD N. DARTMOUTH, MASS. Policy Number : AKG 4943BU Loss of : WGT OF SNOW 01/12/1996 File or Claim #: NB 27930 Claim has been made involving loss , damage or destruction of the above-captioned property, which may either exceed $1 ,000.00 or cause Mass . Gen. Laws , Chapter 143 , Section 6 to be applicable. If any notice under Mass . Gen. Laws , Ch. 139, Sec . 3B is appro- priate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number, date of loss and claim or file number . 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 . Michael Sullivan Adjuster Date: 2-2-96 FRIEDLINE, CARTER & JOHNSON ADJUSTMENT 1 Welby Road, P.O. Box 50128 New Bedford, MA 02745-0005 Tel . ( 508 ) 998-2113 '- Fax. ( 508 ) 998-2136 FFB 5 `i!11 1 .. TO: ( 4 Building Commissioner or Inspector of Buildings (I ) Board of Health or Board of Selectman ( ) Fire Department TOWN OF DARTMOUTH TOWN HALT, DARTMOUTH, MA RE: Insured: ROGERS, WALTER & ALICE Property Address : 115 PINE ISLAND ROAD N. DARTMOUTH, MASS. Policy Number : AKG 4943BU Loss of : WGT OF SNOW 01/12/1996 File or Claim #: NB 27930 Claim has been made involving loss , damage or destruction of the above-captioned property, which may either exceed $1 ,000.00 or cause Mass . Gen. Laws , Chapter 143 , Section 6 to be applicable. If any notice under Mass . Gen. Laws , Ch. 139, Sec. 3B is appro- priate please direct it to the attention of the writer and include a reference to the captioned insured, location, policy number , date of loss and claim or file number . 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 . Michael Sullivan Adjuster Date: 2-2-96