HomeMy WebLinkAboutmold 7.28.2024MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02'l 08-'l 904
(617) 723-3800 Ma Onlv t800) 392.6,l08, FAX (800) 851.8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch,139, Sec.38
8t17t2024
YARI\,4OUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARiI,,|OUTH [4A 02664
JENNIFER THOMAS
87 COOLIDGE RD, WEST YARMOUTH. MA
1426128
Mold caused by: Water Damage
07t28t2024
481306
02675
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 orcause Massachusetts General Laws. Chapter 143, section 6to be applicable. Ifany
notice under Massachusetts General Laws, Chapter 139, Section 38 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 Divislon
ctvA00021
Re: Insured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number: