HomeMy WebLinkAboutice dams 2015MASSACHUSETTS PROPERTY INSURANCE UNOERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(617) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under lvlass. Gen. Laws, Ch.139, Sec.38
515t2015
YARI\,,1OUTH FIRE DEPT
96 OLD l\,,lAlN ST
SOUTH YARIVOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
oate of Loss:
Claim Number:
RUTH S, HOLLAND
108 CENTER ST,. YARMOUTH PORT. MA 02675
1'159382
lce Dams
04114t2015
338683
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed$1000.00orcaUse@tobeapplicable.lfany
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.
MPIUA Claims Division
cMA00021