WATER DAM INS LOSS LTR 08/23/2019 MASSACHUSETTS PROPERTY INSURANCE Ufa.-;K'," ']TING ASSOCIATION
Two Center Piaza
Boston, Massachusetts 0,, 08-1,404
(617)723-3800 Ma Onlv(800)392-6169, FAX(800)851-8424
8/27/2019
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws,Ch.139, Sec.313
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: MICHELLE C DESMOND-POST&BRE1,1 50N ?O a T
Property Address: 62 BEAVER ST, SALEM, MA 01970
Policy Number: 1055782
Type Loss: Water Damage:All Other Water Damagt..
Date of Loss: 08/23/2019
Claim Number: 441982
Claim has been made involving joss,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
GMA00021