HomeMy WebLinkAboutwater damage 2014MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-l 904
(617) 723.3800 Ma Onlv (800) 392-6'108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139. Sec.3B
11312015
YARMOUTH FIRE DEPT
96 OLD I,(AIN ST
SOUTH YARI,,IOUTH MA 02664
Re
cMA00021
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
ROSEANNE LIPE TRUSTEE LIPE REALry TRUST
2 AFT ROAD LOT 1, SOUTH YARMOUTH. MA O26M
1013453
Water Damage: All other Water Damage
1213112014
328481
Claim has been made involving loss, damage or destruction of the above captioned prope(y, which may either
exceed$1000.00orcaUSe@tobeapplicable.lfany
notice 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 frle number.
l\,,lPlUA Claims Division