HomeMy WebLinkAboutice dams 2015MASSACHUSETTS PROPERTY INSURANCE UNOERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1 904
{617} 723-3800 Ma Onlv (800} 392-6108, FAX (800) 851-8424
Form of Notlce ol Casualty Loss to Building
Under Mass. Gen. Laws. Ch.139, Sec.3B
5t12t2015
YARMOUTH FIRE DEPT
96 OLD I/AIN ST
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
DENNY & ALTA HIGH
16 BENJAI\4IN WAY. WEST YARMOUTH. IIIA 02673
0774555
lce Dams
05t11t2015
338960
Re
Claim has been made involving loss, damage or destruction ol the above captioned property, which may either
exceed $1000.00 or cause Massachusetts General Laws. Chaoter '143, section 6 to be applicable. lf any
notjce under i.4assachusetts General Laws. 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 number, date of loss
and claim or file number,
MPIUA Claims Division
cMA00021