11 LYNN STREET - NOTICE LOSS MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Oniv(800)392-6108,FAX(800)851-8424
1/22/2022
Form of Notice of Casualty Loss to Building
Under Mass.Gen. Laws. Ch.139 Sec.3B
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: LEVON KACHERIAN AND BETH KACHERIAN
Property Address: 11 LYNN ST, SALEM,MA 01970
Policy Number: 1424199
Type Loss: Water Damage: Plumbing Systems
Date of Loss: 01/19/2022
Claim Number: 462985
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
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