HomeMy WebLinkAboutwater damage - appliance failure 2025MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02,l08-1904
(617) 723-3800 Ma Onlv (800) 392-6108. FAX (800) 85,|-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139. Sec.3B
10t4t2025
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
Re lnsu red:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
WILLIAM R. BAYTON JR. & SHELLY N. BAYTON
4 ACRES AVE., WEST YARMOUTH. MA 02673
09881'10
Water Damage: Appliance failure
10t02t2025
487808
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 orcause Massachusetts General Laws. Chapter 143. section 6tobe applicable. Ifany
notice under Massachusefts General Laws, Chaoter 139, Section 38 is appropriate, please direct it to the
attention of the wnter and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
lrlPlUA Claims Division
C[,4A00021