HomeMy WebLinkAboutClaim of Loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108,FAX(8001 851-8424
10/4/2018
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: THEODORE R.&SIOBHAN ELDREDGE
Property Address: 26 ROSE ROAD.SOUTH YARMOUTH,MA 02664
Policy Number: 0819242
Type Loss: Mold caused by:Windstorm
Date of Loss: 05/11/2018
Claim Number: 432779
Claim has been made involving loss,damage or destruction of the above captioned properly,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