33 OAKLAND STREET 9-20-24 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
9/28/2024
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139. Sec.313
RECEIVED
SALEM HEALTH DEPT OCT U 7 2024
SALEM CITY HALL
SALEM MA 01970 CITY OF SALEM
BOARD OF HEALTH
Re: Insured: MARK DAVIDSON
Property Address: 33 OAKLAND ST, SALEM, MA 01970
Policy Number: 1445830
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 09/20/2024
Claim Number: 481947
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