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FRIEDLINE&CARTER ADJUSTMENT; INC.
436 Main Street, P. O. Box 338
Hyannis, Massachusetts 02601
_Tel. (508) 771-3232
FAX (508) 790-2344
TO: (-)'Building Commissioner or Inspector of Buildings
( ) Board of Health or Board of Selectmen
O Fire Department
TOWN OF BARNSTABLE
TOWN HALL
HYANNIS, MA
RE: Insured: BOULDRY, Pamela A
Property Addre s: 32 Grove Street
Hyannis
Policy Number: . H09901704
Type of Loss: Fire
Date of Loss: 4/16/2005
File#: 102247
Claim has been made involving loss, damage or destruction of the above captioned
property, which may either exceed $1,000.00 or cause Mass. General Laws, Chapter,143,
Section 6 to be applicable. If any notice under MGL, Ch. 139, Sec. 3B is appropriate,
please direct it to.the attention of this writer and include a reference to the captioned
insured, location,.policy number, date of loss and 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.
G. D. BRIDGE
Adjuster
5/25/2005