24-26 Lafayette Place 10-15-19 claim MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(6171723-3800 Ma Only(800)392-6108, FAX(800)851-8424
10/18/2019
Form of Notice of Casualty Loss to Building
Under Mass. Gen.Laws, Ch.139,Sec.313 RECEIVED
OCT 2 4 2019
SALEM HEALTH DEPT. CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
SALEM MA 01970
Re: Insured: PAUL LHEUREUX AND DENISE LHEUREUX
Property Address: 24-26 LAFAYETTE PLACE,SALEM, MA 01970
Policy Number: 1287222
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 10/15/2019
Claim Number: 443093
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