HomeMy WebLinkAboutNotice of Casualty LossMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-'l 904
(617) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under l\.4ass. Gen, Laws, Ch,'139, Sec.3B
6t21t2025
YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARI\4OUTH MA 02664
Re:Insured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
JON MICHAEL COHEN & LINDA COHEN
2 ROGERS AVENUE. SOUTH YARMOUTH, I\,'!A
1079474
All Other Section I Losses
0611012025
486027
02664
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, Chaoter 143, section 6to be applicable. lfany
notice under l\4assachusetts General Laws. Chaoter 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 flle number.
Ir.4PlUA Claims Division
ctvA00021