HomeMy WebLinkAboutNotice of Loss 061722 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108. FAX(800)851-8424
6/25/2022
Form of Notice of Casualty Loss to Building
Under Mass, Gen. Laws, Ch.139, Sec.3B
RECEIVED
YARMOUTH BUILDING DEPT
1146 ROUTE 28 JUN 2 9 2022
SOUTH YARMOUTH MA 02664
BUILDING DEPARTMENT
By.
Re: Insured: CARL H.JOHNSON
Property Address: 29-31 SOUTH STREET, SOUTH YARMOUTH, MA 02664
Policy Number: 1413910
Type Loss: Water Damage: Plumbing Systems
Date of Loss: 06/17/2022
Claim Number: 466038
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