HomeMy WebLinkAboutinsurance claim 12.13.2024MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-1 904
(617) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen., Ch.139, Sec.3B
1t4t2025
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA O26M
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
DORTHY MARTIN SIMONE TRUSTEE OF
185 LONG POND DRIVE. SOUTH YARMOUTH. MA
0912254
All Other Section I Losses
12113t2024
483253
02664
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00orcause lvlassachusetts General Laws. Chaoter 143. section 6to be applicable. 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.
[.4PlUA Claims Division
cMAo0021