HomeMy WebLinkAboutNotice of Loss 111020 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108.FAX(800)851-8424
11/12/2022
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: EDWIN AND GENEVIEVE RAMIREZ
Property Address: 24-26 ANCHORAGE LANE,WEST YARMOUTH, MA 02673
Policy Number: 1420595
Type Loss: Mold caused by:Water Damage
Date of Loss: 11/10/2020
Claim Number: 468414
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
RECEIVED
NOV 17 2022
BUILDING DEPARTMENT