HomeMy WebLinkAboutNotice of DamageMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1 904
(617) 723-3800 Ma Onlv (800) 392-6108. FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under l\4ass. Gen. Laws, Ch.139, Sec.3B
IAN '12 2026
1t17t2026
YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTHYARMOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
JUSTIN CARDILLO AND KIMBERLY KELLEY
15 CIRCUITRD W. WESTYARMOUTH. MA 02673
1682126
Other Causes of consequential Mold
01t1212026
489322
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. Chapter 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 Iile number.
MPIUA Claims Division
cMAo0021