Notice of Loss 120422 RECEIVED
DEC 07 2022
Narragansett Bay
Insurance BUILDING DEPARTMF_NT
ly;
December 5, 2022
Town of Yarmouth
Building Department
1146 Route 28
South Yarmouth, MA 02664
RE: Policyholder: David Piver
Policy Number: MAH0003762
Claim Number: N114456
Date of Loss: December 4, 2022
Loss Location: 42 Pebble Beach Way, South Yarmouth, MA 02664
To Whom It May Concern:
Claim has been made involving loss, damage or destruction of the above referenced property, which
may exceed either$1000 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 this writer and include a reference to the above captioned
insured, location, date of loss, and claim number.
Title: Property Claims Adjuster
On this date, I caused copies of this notice to be sent to the persons named above at this address
indicated above by first class mail.
Sincerely,
Charles Ferrari
Property Field Claims Examiner
401-495-8945
cferrari@nbic.com
PO Box 820 I Pawtucket,Rhode Island 02862
t 401.725.5600 I f 401.721.0700 I www.nbic.com