4 FAIRVIEW AVENUE - NOTICE LOSS MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392.6108.FAX(800)851-8424
1/15/2022
Form of Notice of Casualty Loss to Building
Under Mass.Gen. Laws. Ch.139. Sec.313
SALEM BUILDING COMMISSIONER
SALEM CITY HALL
SALEM MA 01970
Re: Insured: ALEXANDER V NORTON JR&LISA NORTON
Property Address: 4 FAIRVIEW AVENUE, SALEM, MA 01970
Policy Number: 1247402
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 10/27/2021
Claim Number: 462668
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 36 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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JA