HomeMy WebLinkAbout40 Pleasant Loss NoticeMASSACHUSETTS PROPERTY INSURANCE U NDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-1 904
(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
818t2026
RECEIVED
AULi 12?026
HEALTH DEPT.
YARMOUTH HEALTH DEPT
1't46 ROUTE 28
SOUTHYARMOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
DALE ROBERTS
40 PLEASANT ST. S YARMOUTH. MA
1562527
Water Damage: Plumbing Systems
08t04t2026
494702
02664
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. 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
cMA00021