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Home My WebLink AboutNotice of Loss 12/22/25 THEN ORFOLKODEDHAMGROUP® Norfolk&Dedham Mutual Fire Insurance Co. Dorchester Mutual Insurance Co. Fitchburg Mutual Insurance Co. December 30,2025 FORM OF NOTICE OF CASUALTY LOSS TO BUILDING UNDER MASS.GEN.LAWS,CH.139,SEC.3B Building Commissioner,or Inspector of Buildings RECEIVED do City or Town Hall 1146 Route 28 JAN 05 2026 South Yarmouth,MA 02664 BUILDING DEPARTMENT Board of Health or Board of Selectmen By do City or Town Hall 1146 Route 28 South Yarmouth,MA 02664 Fire Department or Arson Squad c/o City or Town Hall 1146 Route 28 South Yarmouth,MA 02664 RE: Our File No.: P2568127 Insured: PETER STANLEY MARY STANLEY Address: 2 CONGRESSIONAL DRIVE,YARMOUTH PORT,MA Policy No.: H2117725A Loss Date: 12/22/2025 Loss Type: Building or Other Structure Damage A claim has been made involving loss,damage or destruction of the above captioned property, which may either exceed $1,000.00 or cause Mass. Gen. Laws, Ch. 143, Sec. 6 to be applicable. If any notice under Mass.Gen.Laws,Ch. 139,Sec.3B is appropriate,please direct it to my attention and include a reference to the captioned insured,location,policy number,loss date and claim or file number. If no reply is received from your office within ten days,we will assume you have no liens of any type against this property,and the claim will be paid in our customary manner. Sincerely, Richard Jacobson Property Claims Examiner 1-800-688-1825 x1265 Home Office 222 Ames Street,P.O.Box 9109 SINCE 1825 Dedham,MA 02027-9109 Phone:(800)688.1825