HomeMy WebLinkAboutForm of NoticeMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusens 021 08.1 904
(617) 723.3E00 Ma 0nlv (800) 392-6108, FAX (800) 851.8424
Form of Notice of Casualty Loss to Building
Under [4ass. Gen.ws, Ch.139, Sec.3B
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6t28t2025
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YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARI\,IOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
JOHN MERCK
19 ELTON RD. WEST YARI,IOUTH, MA
'1579111
Water Damage: All Other Water Damage
06t13t2025
486113
02673
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00orcause Massachusetts General Laws, Chaoter 143. section 6to be applicable. lfany
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