HomeMy WebLinkAboutNotice of Loss 33122 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
6/21/2022
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: CRAIG AND ROBIN BRICKLEY
Property Address: 38 GARDINER LANE, SOUTH YARMOUTH, MA 02664
Policy Number: 1176784
Type Loss: Smoke
Date of Loss: 03/31/2022
Claim Number: 465964
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 Cha ter 143 section 6 to be applicable. If any
notice under Massachusetts General Laws Charter 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
IRECEIVED]
- 1 JUN 2 3 2022 i 1
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BUILDING DEPARTMENT
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