HomeMy WebLinkAbout2 Lablan Loss NoticeMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(61il 723-3800 Ma Onlv (800) 392-6108. FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139, Sec.3B
5t23t2026
YARMOUTH HEALTH DEPT
1 146 ROUTE 28
SOUTHYARMOUTH MA 02664
Re: lnsured:
Property Address
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
DAVID M & LORIV FELLOWS. TRUSTEES OF
2 LABAN LN. SYARMOUTH. MA 02664
1627110
Fire (including Fire caused by Lightning
05t1812026
493217
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, Chaoter 143, section 6 to be applicable. lf any
notice under Massachusetts General Laws, Chapter 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.
MPIUA Claims Division
cMAo0021