HomeMy WebLinkAboutClaim of Loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
1617)723-3800 Ma Only(800)392.6108,FAX(800)851.8424
10/31/2018
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: EDWARD B AND KATHRYN M MASSEY
Property Address: 50 GENEVA ROAD,SOUTH YARMOUTH,MA 02664
Policy Number: 1085897
Type Loss: Water Damage:Plumbing Systems
Date of Loss: 10/28/2018
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Claim Number: 433423
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,Chanter 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 ' EC E IIS J
NOV 05 2018 ;
BUILD?!G to 'AR-MIEN