HomeMy WebLinkAboutMiscellaneous - 561 MASSACHUSETTS AVENUE 4/30/2018 (2) MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424
11/1/2011
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.36
NORTH ANDOVER HEALTH DEPT.
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845
Re: Insured: ALBERTO&MARY V FLAHERTY ANGLES
Property Address: 561 MASS AVE,NORTH ANDOVER,MA 01845
Policy Number: 1117462 RECEIVED
Type Loss: Windstorm due to:Other Causes
Date of Loss: 10/19/2011 NOV
Claim Number: 296638 TOWN OF NORTH ANDOVER
HEALTH DEPARTMENT
Claim has been made involving loss,damage or destruction of the above captioned propert,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
I
� I