139 Ocean Avenue West 4-4-19 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
4l512019
Form of Notico of Casualty Loss to Building RECEIVED
Under Mass.Gen.Laws, Ch.139, Sec.313
APR 1 2'2019
CITY OF SALEM
SALEM HEALTH DEPT. BOARD OF HEALTH
SALEM CITY HALL
SALEM MA 01970
Re: Insured: STEVEN R&DONNA M FINEBERG
Property Address: 139 OCEAN AVE W.SALEM,MA 01970-2918
Policy Number: 0761300
Type Loss: Fire(including Fire caused by Lightning
Date of Loss: 04/04/2019
Claim Number: 437424
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 Char..4er 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