15 POND STREET 6-1-22 CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(6171723-3800 Ma Only(8001392-6108.FAX(800)851-8424
12/17/2022
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139 Sec.313 RECEIVED
DEC 2 7 2022
SALEM HEALTH DEPT. CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
SALEM MA 01970
Re: Insured: GIOVANNI&CARMEN BATISTA
Property Address: 15 POND ST.,SALEM, MA 01970
Policy Number: 0662751
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 06/01/2022
Claim Number: 468807
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 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
and claim or file number.
MPIUA Claims Division
CMA00021