HomeMy WebLinkAboutNotice of Loss 2025MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08.1904
(6,l7) 723-3800 Ma Onlv (800) 392.6,l08, FAX (800) 85'1.8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen., Ch.139. Sec.38
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10 tt
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HEAL\YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARI\4OUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
RUTH S. HOLLAND
108 CENTER ST.. YARMOUTH PORT. MA
1159382
Water Damage: All Other Water Damage
12103t2025
488737
02675
Re
cMAo0021
Clarm has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 or cause Massachusetts General Laws. Chaoter 143, sectjon 6to be applicable. If any
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.
IVPIUA Claims Division
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