HomeMy WebLinkAboutwater damage 19 elton001MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08.1904
(6171723-3800 Ma Onlv (800) 392.6108. FAX (800) 851.8424
Form of Notice of Casualty Loss to Building
Under Mass.Gen. Laws. Ch.139. Sec.3B
6t28t2025
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
oate of Loss:
Claim Number:
JOHN MERCK
19 ELTON RD. WEST YARMOUTH. MA
1579111
Water Damage: All other Water Damage
06t13t2025
4861'13
02673
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 orcause Massachusetts General Laws. Cha0ter 143, section 6to be applicable. lfany
notice under l\.4assachusetts General Laws. ChaDter 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.
MPIUA Claims Division
cMA00021