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 l\,lass. Gen, Laws. Ch.139, Sec.3B
5t31t2015
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
Re
crvA00021
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
WSSAM TAREK
19 CRANBERY LANE, SOUTH YARMOUTH, MA 02664
1237852
lce Dams
0512612015
339652
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 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,
l\4PlUA Claims Division