HomeMy WebLinkAboutClaim of Loss MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108.1904
(617)723-3800 Ma Only(8001 392-6108,FAX(800)851-8424
11/29/2018
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
RECEU, '= D
YARMOUTH BUILDING DEPT
1146 ROUTE 28 DEC 06 231.9
SOUTH YARMOUTH MA 02664 •
BUILDING DE
ey:
Re: Insured: ROBERT SILVERMAN TRUSTEE OF THE
Property Address: 73 WHITE ROCK ROAD,YARMOUTHPORT,MA 02675
Policy Number: 1201357
Type Loss: Water Damage:Plumbing Systems
Date of Loss: 11/27/2018
Claim Number: 434172
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,Chanter 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