HomeMy WebLinkAboutwater damage 2015MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1 904
(617) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under l\4ass. Gen. Laws, Ch.139, Sec.38
5t19t2015
YARMOUTH FIRE DEPT
96 OLD MAIN SI
SOUTH YARI\,,IOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
oate of Loss:
Claim Number:
JEAN-GUY WASFY
9 CHRISTI,IAS WAY. SOUIH YARMOUTH, I\,IA
1155304
Water Damage: Appliance failure
05/11/2015
339255
02664
Re
ct\.4A00021
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 ol loss
and claim or llle number.
l\,4PlUA Claims Division