HomeMy WebLinkAboutmold Sep 2015i,IASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSoCIATION
Two Center Plaza
Boston, ltlassachusetts 02108-1904
(617) 723-3800 ila Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice ol Casualty Loss to Building
Under [4ass. Gen. Laws, Ch.139. Sec.38
9/16/2015
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
LUCILLE NOBLE
16 CARVER RD, WEST YARMOUTH. MA
0651352
Other Causes ol consequential Mold
09/15/2015
400237
02673
Claim has been made involving loss, damage or destruction of lhe above captioned property, which may either
exceed $'1000.00 or cause Massachusetts General Laws. Chaoter 143, section 6 to be applicable. lf any
notrce is appropnate, 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.
cMA00021
MPIUA Claims Division