HomeMy WebLinkAboutinsurance claim 4.25.2025MASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-1904
(617) 723.3800 Ma 0nlv (800) 392.6108. FAX (800) 851.8424
Form of Notice of Casualty Loss to Building
Under [4ass. Gen.ws, Ch.139, Sec.38
4t26t2025
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
ROBERT MORIN
8 CYGNET RD. W YARMOUTH. MA
1496770
Other Physical Damage
04t25t2025
485135
02673
MPIUA Claims Division
c[,1A00021
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
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 l\,lassachusetts 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 file number.