6 Cypress Street 5-7-21 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
5/11/2021
Form of Notice of Casualty Loss to Building
Under Mass.Gen. Laws. Ch.139Sec.313 RECEIVED
MAY 17 2021
SALEM HEALTH DEPT.
CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
SALEM MA 01970
Re: Insured: FAKHRI BAKR
Property Address: 6 CYPRESS ST, SALEM, MA 01970
Policy Number: 1380061
Type Loss: Fire(including Fire caused by Lightning
Date of Loss: 05/07/2021
Claim Number: 455607
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. Cha.-ter 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