HomeMy WebLinkAbout2024 Property Loss Notice MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(617)723-3800 Ma Only(8001 392-6108, FAX(800)851-8424
3/2/2024
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: LEONID KLEBANOV
Property Address: 31 ICE HOUSE RD. S YARMOUTH, MA 02664
Policy Number: 1616965
Type Loss: Water Damage:All Other Water Damage
Date of Loss: 03/01/2024
Claim Number: 478548
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
tj 1024
HEALTH DEPT.