HomeMy WebLinkAboutNotice of Loss or Damage - 159 Wood RdMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02,l08.1904
(6,l7) 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
9t13t2025
YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARMOUTH l\,lA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
EVANGELINE FREEMAN AND BRYCE FREEI\,4AN
159WOODRD. SYARMOUTH. MA 02664
1706452
Water Damage: All Other Water Damage
09t0612025
487407
Re
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 or cause Massachusetts General Laws, Chaoter 143. section 6 to be applicable. lfany
notice under Massachusetts General Laws. Chapter 139, Seclion 3B is appropriate, please direct it to the
aftention 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
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