HomeMy WebLinkAboutMiscellaneous - 64 COCHICHEWICK DRIVE 4/30/2018 (2) ��
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MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617) 723-3800, Ma Only(800) 392-6108, Fax (617) 557-5675
04/14/04
Form of Notice of Casualty Loss to Building
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Under Mass. Gen. Laws Ch. 139 Sec.313
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NORTH ANDOVER HEALTH DEPT. "`
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845 �-_�•
Re: Insured: THOMAS M. KILEY
Property Address. 64 COCHICHEWiCK DRIVE, N. ANDOVER, MA 01845 I
Policy Number: 0671673
Type Loss: Other Section I losses
Date of Loss: 04/01/04
Claim Number: 207269
Claim has been made involving loss, damage or destruction of the above captioned property,
which may either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143,
Section 6 to be applicable. If any notice under Massachusetts General Laws, chapter 139,
Section 3 B 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
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CMA00021