HomeMy WebLinkAboutClaim of loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108.1904
(6171723.3800 Ma Only(8001392.6108,FAX 18001 851-8424
10(3112018
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
YARMOUTH BUILDING DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: DANNY VOGEL AND MARY VOGEL
Property Address: 30 RIVER STREET,SOUTH YARMOUTH,MA 02664
Policy Number: 1406870
Type Loss: Water Damage:All Other Water Damage.
Date of Loss: 10/30/2018 •
Claim Number: 433416
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 RECEIVED
NOV os 2018
( nUILDING DEPART
MENT