HomeMy WebLinkAboutice dams 2015MASSACHUSETTS PROPERW INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108-1904
(61il 723-3800 Ma Onlv (800) 392-6108. FAX (800) 8s1-8424
Form of Notice of Casualty Loss to Building
Under l\.4ass. Gen. Laws, Ch.139, Sec.3B
2t19t2015
YARMOUTH FIRE DEPT
96 OLD MAIN ST
SOUTH YARMOUTH MA 02664
Re
cMA0002 r
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
LUCILLE NOBLE
16 CARVER RD. WEST YARMOUTH, MA 02673
0651352
lce Dams
0211712015
331022
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. 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 ol loss
and claim or file number.
N,,1PlUA Claims Division