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64 Insurance Loss 2021MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION Two Center Plaza Boston, Massachusetts 02108.1904 (617)723.3800 Ma Only (800) 392-6108, FAX (800) 851-8424 HEALTH DEPT. PUCHALSKI MUNICIPAL BUILDING 212 MAIN STREET NORTHAMPTON MA 01060 Re: Insured: Property Address: Policy Number: Type Loss: Date of Loss: Claim Number: CMA00021 Form of Notice of Casualty Loss to Building Under Mass. Gen. Laws, Ch.139, Sec.313 JAMES NORTH AND SUSAN NORTH 64 FLOREST GLEN DR, FLORENCE, MA 01062 1438235 Windstorm Other than Hurricane or Tornad 03/01/2021 454292 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 3/4/2021