HomeMy WebLinkAboutinsurance claim - boiler 2025MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02,l08-1904
(517) 723-3800 Ma Onlv (800) 392-5108. FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139. Sec.3B
91612025
YARI/OUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH I\,4A 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
CIaim Number:
ROBERT AND SANDRA ROYSTER. TRUSTEES
20 HOPE ROAD. SOUTH YARMOUTH. MA O26M
1173182
Fumace/Boiler
09t0212025
4873M
Claim has been made involving loss, damage or destruction of the above captloned property, which may either
exceed $1000.00 or cause Massachusetts 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 wnter and include a reference to the captroned insured, location, policy number, date of loss
and claim or file number.
MPIUA CIaims Division
c t\.,1A00021