HomeMy WebLinkAboutice dams 2015MASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATION
Two Centor Plaza
Boston, Massachusefts 021 08-1 904
(6'17) 723-3800 Ma Onlv (8001 392-6108, FAX (800) 851'8424
Form of Notice of Casualty Loss to Building
Under [4ass. Gen.. Ch.139. Sec.38
3t13t2015
YARMOUTH FIRE DEPI
96 OLD I,,IAIN ST
SOUTH YARI,,IOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
ANNE M LIBERTY
34 ARLINGTON STREET. WEST YARMOUTH. IIA 02673
1 123649
lce Dams
03/04/2015
334345
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 or cause l\,lassachusetts General Laws. ChaDter 143, section 6 to be applicable. lf any
notice under Mas General Laws, Chapler 139, Section 38 is appropriate, please direct it to the
attention ol the writer and include a reference to the captioned insured, localion, policy number, date of loss
and claim or file number.
N4PIUA Claims Division
cMA00021