HomeMy WebLinkAboutNotice of Loss 102222 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
11/5/2022
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws,Ch.139, Sec.3B
RECEIVED
YARMOUTH BUILDING DEPT TIOViOj 2022
1146 ROUTE 28
SOUTH YARMOUTH MA 02664 BUILDING DEPARTMENT
By —
Re: Insured: DONALD GIBBS AND CAROLE GIBBS
Property Address: 28 CAPTAIN DANIEL ROAD, SOUTH YARMOUTH, MA 02664
Policy Number: 1377564
Type Loss: Other Physical Damage
Date of Loss: 10/22/2022
Claim Number: 468311
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