HomeMy WebLinkAboutInsurance Claim - Miscellaneous - 114 BEVERLY STREET 8/21/2023 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Onlv(800)392-6108. FAX(800)851-8424
8/12/2023
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
NORTH ANDOVER HEALTH DEPT.
NORTH ANDOVER TOWN HALL
NORTH ANDOVER MA 01845
Re: Insured: CAMILLE ADLER ROTH AND ELI ADLER ROTH
Property Address: 114 BEVERLY ST, NORTH ANDOVER, MA 01845
Policy Number: 1548885
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 08/08/2023
Claim Number: 474308
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, 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