HomeMy WebLinkAboutNotice of Loss 110722 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: PAULA HENNESSY TRUSTEE OF THE SMITH
Property Address: 168 WOOD RD, S YARMOUTH. MA 02664
Policy Number: 1574676
Type Loss: Other Causes of consequential Mold
Date of Loss: 11/07/2022
Claim Number: 468379
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 R
NOV 17 2022 f
BUILDING