HomeMy WebLinkAboutNotice of Damage - 31 S Shore DrMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-1 904
(617) 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
9127t2025
YARI\,4OUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
SAI\4ANTHA JOSEPH
31 S SHORE DR. S YARMOUTH, l\,lA
1660229
Other Physical Damage
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487691
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02664
Claim has been made involving loss, damage or destruction ol the above captioned property, which may either
exceed $1000.00 or cause Massachusetts General . Chaoter'143. section 6 to be applicable. lf any
notice under l\,lassachusetts General 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 numbef, date of loss
and claim or file number.
MPIUA Claims Division
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