HomeMy WebLinkAboutwater damage 2026MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108'1904
(617) 723-3800 Ma Onlv (8001392'6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen . Ch.139. Sec.3B
YARI\,IOUTH FIRE DEPT
96 OLD l\,lAlN ST
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
J SCOTT MARTIN TRUSTEE OF
6 WILLOW LN. S YARMOUTH. MA
158M16
Water Damage: Appliance failure
03124t2026
492278
Re
02664
l\.,lPlUA Claims Division
cMAo0021
3t2812026
Claim has been made involving loss, damage or destruction of the above captioned Foperty, which may either
exceed $1000.00 orcause Massachusetts General Laws. ChaDter 143. section 6 to be applicable. lfany
notice under Massachusetts General Laws. Chaoter 139. Section 38 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.