171 MARLBOROUGH ROAD 10-29-25 CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723.3800 Ma Only(800)392-6108,FAX(8001851-8424
11/1/2025
Form of Notice of Casualty Loss to Building RECEIVED
Under Mass. Gen. Laws Ch.139.Sec.313
NOV 0 5 2025
CITY OF SALEM
SALEM HEALTH DEPT BOARD OF HEALTH
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