Loading...
0003 1/2 BENTLEY STREET - BUILDING IJACKET LniversaL MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108-1904 (617)723-3800 Ma Only(800)392-6108,FAX(8001851-8424 3/6/2015 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: JOHN DORON Property Address: 31/2 BENTLEY STREET,SALEM.MA 01970 Policy Number: 0603149 Type Loss: Ice Dams Date of Loss: 02/17/2015 Claim Number: 333376 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 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston,Massachusetts 02108.1904 16171723.3800 Me Only(800)392-6108,FAX 18001851-8424 31612015 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: JOHN DORON Property Address: 3 1/2 BENTLEY STREET.SALEM, MA 01970 Policy Number: 0603149 Type Loss: Ice Dams Date of Loss: 0211712015 Claim Number: 333376 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 Chanter 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 w