HomeMy WebLinkAboutNotice of Loss 110222 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
,_RECEIVE ®
YARMOUTH BUILDING DEPT NOV 10 2022
1146 ROUTE 28
SOUTH YARMOUTH MA 02664 BUILDING DEPARTMENT
BY - -
Re: Insured: ALISSA A. BENJAMIN
Property Address: 16 TEMPLETON PL, WEST YARMOUTH, MA 02673
Policy Number: 1185470
Type Loss: All Other Section I Losses
Date of Loss: 11/02/2022
Claim Number: 468287
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