HomeMy WebLinkAboutProperty Loss Notice 2026MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02108'1904
(6171723-3800 Ma Onlv (800) 392.6108. FAX (800) 851-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws. Ch.139. Sec,3B
9t12t2026
Re: lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
RECEIVED
stP 1 / 2026
HEALTH DEPT.
JEFFREY J HART
48 TALL PINES DRIVE, YARMOUTH. MA
0758088
Water Damage: All Other Water Damage
08t2612026
495260
02675-2517
Claim has been made involving loss, damage or destruction of the above captjoned property, which may either
exceed$1000.00orcause@tobeapplicable.lfany
notice under Massachusetts General Laws. ChaDter 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 of loss
and claim or file number.
ITIPIUA Claims Division
cMAo0021
YARMOUTH HEALTH DEPT
'1146 ROUTE 28
SOUTH YARMOUTH I\,IA 02664