11 LYNN STREET 01-19-22 CLAIM MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(8001392-6108,FAX(800)851-8424
1/22/2022
Form of Notice of Casualty Loss to Building RECEIVED
Under Mass. Gen. Laws. Ch.139, Sec.3B
JAN 312022
SALEM HEALTH DEPT. CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
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