HomeMy WebLinkAboutNotice of Loss 7/28/24 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617)723-3800 Ma Only(800)392-6108, FAX(800)851-8424
8/17/2024
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: JENNIFER THOMAS
Property Address: 87 COOLIDGE RD,WEST YARMOUTH, MA 02675
Policy Number: 1426128
Type Loss: Mold caused by:Water Damage
Date of Loss: 07/28/2024
Claim Number: 481306
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
RECEIVED
[±l16 26 2024
BUILDING DEPARTMENT+