93 OCEAN AVE_ NOTICE OF LOSS 9-5-25 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108.1904
(617)723.3800 Ma Only(800)392.6108,FAX(800)851.8424 912712025
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: WILLIAM TWOMEY
Property Address: 93 OCEAN AVE, SALEM.MA 01970
Policy Number: 1720293
Type Loss: Other Physical Damage
Date of Loss: 09/05/2025
Claim Number: 487654
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,anon, ol 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