HomeMy WebLinkAbout39 Cleveland Property Loss NoticeMASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-,l904
(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
7 t25t2026
YARI\,4OUTH HEALTH DEPT
1146 RoUTE 28
SOUTH YARMOUTH MA 02664
RECETVED
JUi.. 2 s ?0?6
HEAtlH OEPT.
DEIRDRE DENNIS
39 CLEVELAND WAY. WEST YARMOUTH. MA
1625159
Windstorm Other than Hunicane or Tomad
07t21t2026
494416
02673
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 orcause lVassachusefts General Laws. Chaoter'143, section 6to be applicable. lfany
notice under Massachusetts General Laws. Chaoter 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
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number: