HomeMy WebLinkAboutNotice of Loss 102923 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
11/4/2023
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: DENNY&ALTA HIGH
Property Address: 16 BENJAMIN WAY, WEST YARMOUTH, MA 02673
Policy Number: 0774555
Type Loss: Vehicle Damage
Date of Loss: 10/29/2023
Claim Number: 475858
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 Cha ter 143 section 6 to be applicable. If any
notice under Massachusetts General Laws Cha ter 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
R C ivED
CMA00021
NOV 09 2923
BUILDING DEPARTMENT
By: