HomeMy WebLinkAboutClaim of Loss - 10/1/2018 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
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• 1111612018
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
RECEIVED
YARMOUTH BUILDING DEPT NOV 21 2018
1146 ROUTE 28
SOUTH YARMOUTH MA 02664 BUILDING-DEPARTMENT
By --
Re: Insured: DENNY&ALTA HIGH
Property Address: 16 BENJAMIN WAY,WEST YARMOUTH.MA 02673
Policy Number: 0774555
Type Loss: Mold caused by:Water Damage
Date of Loss: 10101/2018
Claim Number: 433881
•
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