HomeMy WebLinkAboutmold Mar 2015MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 021 08-1904
{617) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen.. Ch.139. Sec.3B
3t13t2015
YARMOUTH FIRE DEPT
96 OLD I\,IAIN SI
SOUTH YARMOUIH I\,IA 02664
Re
cMA00021
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
02673
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed$1000.00orcause@tobeapplicable,lfany
notice under Massachusetts General Laws. Chapter 139. Section 3B is appropriate, please direct it to the
attention ol the writer and include a reference to the captioned insured, location, policy number, date ol loss
and claim or file number.
[4PlUA Claims Division
LUCILLE NOBLE
16 CARVER RD, WEST YARMOUTH. MA
0651352
Other Causes of consequential Mold
03t1212015
334445