HomeMy WebLinkAboutinsurance claim 2016MASSACHUSETTS 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 Bu lding
Under Mass. Gen. Laws, Ch.139. Sec.3B
712112016
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARI\4OUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
oate of Loss:
Claim Number:
JUDITH HARMONY
57 ADAMS RD. WEST YARMOUTH. MA 02673
1111232
Oil Section I
07/ 19/2016
407835
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, Chaoter 139, Section 38 is appropnate, 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 Division
cMA00021