37 Hancock Street - Claim Notice MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723-3800 Ma Only(800)392.6108, FAX(800)851.8424
5/14/2022
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: JUDITH E. MIRABILE
Property Address: 37 HANCOCK STREET, SALEM, MA 01970
Policy Number: 1259667
Type Loss: Fire(including Fire caused by Lightning
Date of Loss: 05/10/2022
Claim Number: 465366
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
24
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