HomeMy WebLinkAboutNotice of Loss 4/19/26 MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(6171 723-3800 Ma Only(8001 392-6108,FAX 18001 851-8424
5/2/2026
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
RECEIVEDI
YARMOUTH BUILDING DEPT MAY 07 20261
1146 ROUTE 28
SOUTH YARMOUTH MA 02664 BUILDING DEPARTMENT
By'
Re: Insured: XIAXI LI AND YACHEN SHU
Property Address: 28 GARDINER LN.SOUTH YARMOUTH.MA 02664
Policy Number: 1581374
Type Loss: Water Damage:Plumbing Systems
Date of Loss: 04/19/2026
Claim Number: 492941
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws,Chapter 143,section 6 to be applicable. If any
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 file number.
MPIUA Claims Division
CMA00021