HomeMy WebLinkAboutice dams 2015MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-1904
(617) 723-3800 Ma Onlv (800) 392.6108. FAX (800) 85'l-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen, Laws. Ch,139, Sec.38
6/19/2015
YARI,,IOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARI\4OUTH MA 02664
Re
cMA00021
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
ANGELA PYBAS
10 CEDAR ST. SOUTH YARMOUTH. MA 02664
1233776
lce Dams
0u20nu5
340465
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceeds1000.00orcaUSe@tobeapplicable'lfany
notice under Massachusetts General Laws, Cha0ter 139, Section 38 is appropnate, 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