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1 BEACH AVE_ NOTICE OF LOSS_ 5-10-25 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108.1904 (6171723.3800 Ma Only(800)392.6108, FAX(800)851.8424 5/17/2025 Form of Notice of Casualty Loss to Building Under Mass Gen. Laws Ch.139,Sec.3B SALEM BUILDING COMMISSIONER SALEM CITY HALL SALEM MA 01970 Re: Insured: MAUREEN HENTOSH Property Address: 1 BEACH AVE.. SALEM. MA 01970 Policy Number: 0999108 Type Loss: Water Damage:All Other Water Damage Date of Loss: 05/10/2025 Claim Number: 485388 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