HomeMy WebLinkAboutice dams 2015MASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(6'17) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under l\,1ass. Gen. Laws. Ch.139, Sec.38
3t6t2015
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH I/A 02664
Re lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
JUDITH HARMONY
67 ADAI\4S RD, WEST YARMOUTH. MA 02673
1111232
lce Dams
03/04i2015
333451
MPIUA Claims Division
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 or cause l\,lassachusetts General Laws, Chaoter 143, section 6 to be applicable. lf any
notice under Massachusetts General Laws, Chaoter 139, Section 3B 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 flle number.
ct!.1400021
MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Cenler Plaza
Boston, Massachusetts 021 08-1 904
(617)723-3800 Ma Onlv (8001 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under [4ass. Gen. Laws, Ch.139. Sec.3B
3t5t2015
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
JUOITH HARMONY
67 ADAMS RD. WEST YARMOUTH, MA 02673
1111232
lce Dams
03103t2015
333155
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. Chapter 143, section 6 to be applicable. lfany
notice under Massachusetts General Laws, Chaoter 139, Section 38 is appropriate, please direct it to the
attention ol the writer and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
MPIUA Claims Division
c t\.,tA00021