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
NOV 7 Imo 1
Re: Insured: ELAINE GAMBRAllIO
19 POWERS LANE,WEST YARMOUTH, MA 02673 ey �LDING DtPq�TMENT
PropertyAddress:
Policy Number: 1168806
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 11/07/2022
Claim Number: 468383
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