HomeMy WebLinkAbout28 Willow - Ins Loss NoticeForm of Notice of Casualty Loss to Building
Under l\,4ass. Gen. Laws. Ch.139, Sec.3B
91512026
YARMOUTH HEALTH DEPT
1146 ROUTE 28
SOUTHYARMOUTH MA 02664
Re
cMA00021
lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
02675
Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 or cause Massachusetts General . Chaoter 143. section 6 to be applicable. lf any
notice under l\,lassachusetts General . Chaoter 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 flle number.
MPIUA Claims Division
SUSAN LARRABEE
28 WILLOW STREET, YARMOUTHPORT, IVIA
1363611
Water Damage: Plumbing Systems
08115t2026
495178
MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, ilassachusetts 021 08-1904
(617) 723-3800 Ma onlv (800) 392-6108, FAx (800) 851.8424