HomeMy WebLinkAboutNotice of Loss 010522 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
10/1/2022
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
RECEIVE ®
YARMOUTH BUILDING DEPT $"
1146 ROUTE 28 OCT O 7 2022 (
SOUTH YARMOUTH MA 02664
BUILDING DEPARTMENT
By
Re: Insured: CATHERINE ROBERTS
Property Address: 318 CAMP ST, WEST YARMOUTH, MA 02673
Policy Number: 0702834
Type Loss: All Other Section I Losses
Date of Loss: 01/05/2022
Claim Number: 467728
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