HomeMy WebLinkAboutwater damage 2017ITiASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATIoN
Two Conter Plaza
Boston, irassachusetts 02108-1904
(617) 723-3800]r|a Onlv 18001 392-6108. FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under l/tass. Gen. Laws, Ch.139. Sec.3B
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
ANN L SILVERMAN
1 AKINAVE.SOUTHYARMOUTH. MA 02664
1368032
Water Damage: All Other Water Damage
0612212017
415445
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. Chapter143. section 6to be applicable. lf any
notice under Massachusetts General Laws. Chaoter 139. Section 38 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 file number.
MPIUA Claims Division
cMA00021
612312017