HomeMy WebLinkAboutInsurance Claim MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424
5/24/2019
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
F 1
YARMOUTH BUILDING DEPT f
1146 ROUTE 28 610I. ) C1Z
SOUTH YARMOUTH MA 02664
r,/r
Re: Insured: THOMAS WILLIAMSON
Property Address: 43 WITCHWOOD RD.SOUTH YARMOUTH, MA 02664
Policy Number: 1457989
Type Loss: Water Damage: Plumbing Systems
Date of Loss: 05/19/2019
Claim Number: 438512
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