HomeMy WebLinkAboutinsurance claim 2016Form o[ Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.'139. Sec.3B
7 t22t2016
YARI\4OUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARI/OUTH I\,4A 02664
lnsured:
Property Address:
Pclicy Number:
Type Loss:
Date of Loss
Clsim Number:
EDWIN AND GENEVIEVE RAMIREZ
24.26 ANCHORAGE LANE. WEST YARMOUTH, MA
0969044
All Other Section I Losses
0710112016
107895
02673
Re
Ctu{A00021
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed$,1000'00orcaUse@tobeapplicable,lfanynotice 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.
MPIUA Claims Division
MASSACHUSETTS PROPERW INSURANCE UNOERWRITING ASSOCIATION
Two Center Plaza
Boslon, Massachusetts 02'l 08-1904
(6'17) 723-3800 Ma Onlv (800) 392-6108. FAX (800) 851-8424