HomeMy WebLinkAboutInsurance Claim MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only 1800)392-6108,FAX(800)851-8424
10/23/2019
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
YARMOUTH BUILDING DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: LESLIE BUCKLAND AND DAVID DACOSTA
Property Address: 103 CAPTAIN BACON RD.,SOUTH YARMOUTH, MA 02664
Policy Number: 1374197
Type Loss: Windstorm due to:Tornado
Date of Loss: 07/23/2019
Claim Number: 443607
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 38 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