HomeMy WebLinkAboutNotice of Loss 10/9/2026MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston, Massachusetts 02'l 08- 1904
(617) 723-3800 Ma Onlv (800) 392-6108, FAX (800) 8s1-8424
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws, Ch.139. Sec.38
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YAR[,4OUTH HEALTH DEPT
1146 ROUTE 28
SOUTH YARIUOUTH IVIA 02664
RECEIVET.
ocr 16 202i
HEALTH DEI,,
Re lnsured:
Property Address:
Policy Number:
Type Loss:
Date of Loss:
Claim Number:
SHANNON DANNE.FEENEY
64 BRAY FARM RD N. YARMOUTH PORT. MA
1665672
Water Damage: Plumbing Systems
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496012
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Claim has been made involving loss, damage or destruction of the above captioned property, which may either
exceed $1000.00 or cause [,lassachusetts ceneral Laws. Chapter 143. section 6to be applicable. lfany
notice under Massachusetts General Laws. Chaoter 139, Section 38 is appropriate, please direct itto the
attention of the writer and include a reference to the captioned insured, location, policy number, date of loss
and claim or file number.
MPIUA Claims Division
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