42 ESSEX STREET 5-5-22 CLAIM (002) MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723.3800 Ma Only(8001392-6108,FAX(800)851-8424
5/14/2022
Form of Notice of Casualty Loss to Building
Under Macs. Gen. Laws, Ch.139,Sec.3B RECEIVED
MAY 19 202Z
SALEM HEALTH DEPT. CITY OF SALEM
SALEM CITY HALL BOARD OF HEALTH
SALEM MA 01970
Re: Insured: MEREDITH BAKER
Property Address: 42 ESSEX ST 3R, SALEM, MA 01970
Policy Number: 1464979
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 05/05/2022
Claim Number: 465365
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, Chaoter 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