72 WASHINGTON SQUARE EAST 12-18-22 CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
1/7/2023
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws. Ch.139. Sec.313
RECEIVED
SALEM HEALTH DEPT
SALEM CITY HALL JAN 17 2023
SALEM MA 01970
CITY OF SALEM
BOARD OF HEALTH
Re: Insured: NANCY L SACHETTI TRUSTEE, NANCY
Property Address: 72 WASHINGTON SQ, EAST, SALEM, MA 01970
Policy Number: 1413832
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 12/18/2022
Claim Number: 469395
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