HomeMy WebLinkAboutcrowes purchase 47001MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08.1904
(617) 723-3800 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
7t26t2025
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARI,IOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
Re
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, 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
cr\rA00021
CHERYL DONAHOE TRUSTEE OF
47 CROWE'S PURCHASE RD. WEST YARMOUTH. MA
1478/29
Water Damage: Appliance failure
0711812025
486755