1 Paul Avenue- Claim Notice 31822 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723.3800 Ma Only(800)392.6108. FAX(8001851.8424
4/30/2022
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: RAPHAEL H LUNARDI
Property Address: 1 PAUL AVE, SALEM, MA 01970
Policy Number: 1445123
Type Loss: All Other Section I Losses
Date of Loss: 03/18/2022
Claim Number: 465158
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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