HomeMy WebLinkAboutNotice of Loss 010324 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
1/13/2024
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
YARMOUTH BUILDING DEPT E i 7 D
1146 ROUTE 28
SOUTH YARMOUTH MA 02664 JAN 19 2024
BUILDING DEPARTMENT
By
Re: Insured: GEULA LITCHMAN _
Property Address: 300 BUCK ISLAND RD, WEST YARMOUTH, MA 02673
Policy Number: 1505084
Type Loss: Water Damage:Appliance failure
Date of Loss: 01/03/2024
Claim Number: 477446
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