71 WEATHERLY DRIVE 6-2-26 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
6/13/2026
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws. Ch.139. Sec.313 RECEIVE®
SALEM HEALTH DEPT JUN 23 20Z6
SALEM CITY HALL CITY OF SALEM
SALEM MA 01970 BOARD OF HEALTH
Re: Insured: CHERYL APPEL
Property Address: 71 WEATHERLY DR UNIT 71 SALEM, MA 01970
Policy Number: 1734686
Type Loss: Ice Dams
Date of Loss: 06/02/2026
Claim Number: 493770
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 313 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