HomeMy WebLinkAboutInsurance Claim MASSACHUSETTS PROPERTY INSURANCE UN ERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 0t'08-104
(617)723.3800 Ma Only(800)392-6108,FAX(800)851-8424
8/14/2019
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: THELMA GOLD
Property Address: 6 AVON ROAD,YARMOUTHPORT,MA 02675
Policy Number: 1006928
Type Loss: Water Damage:Appliance failure
Date of Loss: 08/13/2019
Claim Number: 441714
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