HomeMy WebLinkAboutInsurance Claim MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(6171723-3800 Ma Only(8001392.6108,FAX(8001851.8424
6/15/2019
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
i
YARMOUTH BUILDING DEPT f,JN , ,
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: PAUL J.&JOSEPHINE M.SEVIGNY
Property Address: 32 BRAY FARM ROAD SOUTH,YARMOUTHPORT,MA 02675
Policy Number: 0937249
Type Loss: Furnace/Boiler
Date of Loss: 06/05/2019
Claim Number: 438952
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