HomeMy WebLinkAboutInsurance Notice of Claim - Correspondence - 21 WEYLAND CIRCLE 6/18/2019 I ASSACHU ETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plazz,
Boston,Ma sac usetts 0 #1904
(617)723-3300 lea OnIv( 00)392-6103t FA::( 00) 51- 424
/18/201
Form of Notice of Casualty Loss to Building
Under glass.Gen.Laws, h.139,.Sec.313
NORTH ANDOVER BUILDING COMMOSSIONER
NORTH ANDVER TOWN HALL
NORTH AND OVER NSA 0184
Re: Insured: YOSEF ROZENBLIT AND YAEL l AD SHI
Property Address: 21 WEYLAND CIRCLE, NORTH AI D VER,MA 01845
Policy Number: 1336956
Type Doss: Water Damage:All Other Water Darnag
Date of Loss: 08f 1 l2019
Claire Number: 43899
Claim has been made involving lass,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws Chapter 143,section 8 to be applicable. If any
notice under Massachusetts General Craws Chapter 139,Section 3E 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.
iPIA Claims Division
C 1A00021
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