171 MARLBOROUGH RD_ NOTICE OF LOSS 10-29-25 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723-3800 Me Only(800)392.6108.FAX(800)851.8424
11/1/2025
Form of Notice of Casualty Loss to Building
Under Mass Gen Laws Ch.139, Sec.38
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: ANDERSON PENA AND DENISE ALVES
Property Address: 171 MARLBOROUGH RD, SALEM, MA 01970
Policy Number: 1545928
Type Loss: Water Damage: Plumbing Systems
Date of Loss: 10/29/2025
Claim Number: 488262
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
NOV 5 AM10:54
'25 NOV 5