45 Perkins Street 11-2-20 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Onlv(800)392-6108, FAX(800)851-8424
11/5/2020
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws. Ch.139. Sec.3B RECEIVED
NOV 0 9 2020
SALEM HEALTH DEPT. CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
SALEM MA 01970
Re: Insured: MARIO&MARIA C.DUZZ
Property Address: 45 PERKINS STREET, SALEM, MA 01970
Policy Number: 1082834
Type Loss: Water Damage: Plumbing Systems
Date of Loss: 11/02/2020
Claim Number: 451980
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. Cha tep r 143 section 6 to be applicable. If any
notice under Massachusetts General Laws. Cha;jter 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