HomeMy WebLinkAboutNotice of Loss 60122 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723-3800 Ma Only(800)392-6108, FAX(8001851-8424
7/9/2022
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
RECEIVFD
YARMOUTH BUILDING DEPT - — _--
1146 ROUTE 28 JUL 14 2022
SOUTH YARMOUTH MA 02664
BUILDING DEPARTMENT
By:_
Re: Insured: GEORGE&HEATHER WARNER
Property Address: 12 SUFFOLK AVE,YARMOUTH, MA 02673
Policy Number: 0773100
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 06/01/2022
Claim Number: 466335
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