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(800)851-8424
1/8/2019
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139.Sec.3B
sRECEIVED
YARMOUTH BUILDING DEPT
1146 ROUTE 28 JAN 1 Q 2019
SOUTH YARMOUTH MA 02664
BUIL.DIN GDE PA RT ME NT
Re: Insured: BORCHO JOVANOV
Property Address: 15 NAUTICAL LANE,SOUTH YARMOUTH,MA 02664
Policy Number: 1388176
Type Loss: Water Damage:Plumbing Systems
Date of Loss: 01/05/2019
Claim Number. 434858
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