HomeMy WebLinkAboutwater damage 2.19.2025MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617) 723-3800 Ma Onlv (800) 392-6'108, FAX (800) 851-8424
Form of Notrce of Casualty Loss to Building
Under l\,lass. Gen. Laws ch.139 Sec.3B
2t22t2025
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTHYARMOUTH MA 02664
WILLIAM ALEXANDER
40 VIRGINIA ST, WEST YARMOUTH. MA
1652742
Water Damage: Plumbing Systems
02t19t2025
484044
02673
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed$1000'00orcauSe@tobeapplicable.lfany
notice under Massachusetts 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.
MPIUA Claims Division
cMA00021
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number: