HomeMy WebLinkAboutInsurance Letter - Correspondence - 519 FOREST STREET 5/2/2022 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOICIATIOIN
Two Gen'ter Pl,aza
Boston,Mass,achusetts 0211018-1904
(617),1723-38,010 MaOniv(8,1010)392-6108.FAX(800)85,11-8,424
5,17/20122
Form of Notice of Casualty Loss to Building
Under Mass,., Gen,
NORTH ANDOVER BUILDING COMMOSSIONER
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845,
i W,
Reg-, Insured-, LINDA AN�D ANTONIO DEPACE
Property Aiddress,.' 519 FOREST STREET, NORTH ANDOVER, MA 018,45
Polity Number: 122,01895
Type,Loss. Theft
Date of Loss,-., 05/0,2/2022
Claim Number: 465225
,Claim has been made involving Iloss,damage,or destrutfioln of the,above captioned property,which may either
exceed$10,00.,00 or cause Mas sac husett's Gienieral Laws& section 6,to be appllicable% lfany
11 �ha �,te r 1�43 I I
noltice under Massachusetts Gener I Cha � r 139 Sg c �prq, 1 1
priate, please dirlect it to the
attention ofthe wrift and incluide a reference to,the captlotied insured,, locafion,, policy nuniber, date,of'loss
and cla,'I'm or file number.
MPIUIA Claims Division
CMA00021
