HomeMy WebLinkAboutwater damage 8.12.2024MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1904
(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
8t1712024
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUIH YARMOUIH I\,,IA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
SANDRA SCARBOROUGH
2 CAPTAIN PERCIVAL RD. S YARMOUTH. MA
1606506
Water Damage: Plumbing Systems
0811212024
481249
Re
02664
Claim has been made involving loss, damage or destructron of the above captioned property, which may either
exceed $1000,00 or cause Massachusetts General Laws. Chapter 143. section 6to be applicable. lfany
notice under Massachusetts General Laws, Chaoter 139, Section 38 is appropnate, please direct it to the
attention of the Miter and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
[.4PlUA Claims Division
cMA00021