HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 139 COTUIT STREET 3/13/2018 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108.1904
(617)723.3800 Ma Only(800)392-6108,FAX(8001851.8424
3/13/2018
Form of Notice of Casualty Loss to Building
Under Mass.Gen,Laws,Ch.139,Sec.313
NORTH ANDOVER BUILDING COMMOSSIONER
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845
Re: Insured: ROBERT J&PATRICIA ZIEBE
Property Address: 139 COTUIT ST,NORTH ANDOVER,MA 01845
Policy Number: 1187954
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 0310812018
Claim Number: 426040
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 Cha ter 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