HomeMy WebLinkAboutfurnace or boiler insurance claim 2017MASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108.1 904
(61 723-3800 Ma Onlv (800) 392.6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under ilass. Gen, Laws. Ch.139. Sec.3B
4112017
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
DANIEL VALDEZ AND PAMELA VALDZ
36 CAPTAIN CHASE RD. SOUTH YARMOUTH. MA
1249363
Fumace/Boiler
01131t2017
4't'1806
02664
Re
cM400021
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. lfany
notice under Massachusetts General Laws, Chaoter'139, Section 38 is appropriate, please direct it to the
attention of the writer and indude a reference to the captioned insured, location, policy number, date o, loss
and claim or file number.
[.4PlUA Claims 0ivision