Casuality Loss 91622 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
5/27/2023
Form of Notice of Casualty Loss to Building
Under Mass.Gen. Laws,Ch.139,Sec.3B
YARMOUTH BUILDING DEPT
1146 ROUTE 28 \\_. 202r5
SOUTH YARMOUTH MA 02664 G DEPAR=N�
Re: Insured: MARY BIANCHI
Property Address: 88 PAWKAANNAWKUT DRIVE, SOUTH YARMOUTH. MA 02664
Policy Number: 0961171
Type Loss: Theft
Date of Loss: 09/16/2022
Claim Number: 472843
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