HomeMy WebLinkAboutwater damage 2015MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusefts 02108-1904
(617) 723-3800 Ma Onlv (800) 392-6'108, FAX 1800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws. Ch.139, Sec.3B
5t512015
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
0ate of Loss:
Claim Number:
PAMELA WALSH
34 CEDAR STREET. SOUTH YARMOUTH. MA
1283389
Water Damage: Plumbing Systems
05/03/2015
338610
Re
02664
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $'1000.00 or cause l\4assachusetts General Laws, Chaoter 143, section 6 to 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.
N/PIUA Clalms Divlsion
cf/A00021