HomeMy WebLinkAbout0105 CHESTNUT STREET
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S M E A D
No. 10339
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MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
(617)723.3800 Ma Only(8001392-6108,FAX(800)851-8424
12/8/2016
Form of Notice of Casualty Loss to Building
Under Mass.Gen.Laws,Ch.139,Sec.3B
HYANNIS BUILDING DEPT y
200 MAIN ST ,.
HYANNIS MA 02601
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Re: Insured: BRUCK LACKEY&MARLINE LACKEY TRUSTEES L J.
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105 CHESTNUT ST,HYANNIS,MA 02601 ` -` '
Pro a Address: �
Policy Number: 1409410
Type Loss: Fire(including Fire caused by Lightning
Date of Loss: 12/05/2016 rn
Claim Number: 410679
Claim has been made involving loss,damage or destruction of the above captioned property,which may either
exceed$1000.00 or cause Massachusetts General Laws.Chapter.143,section 6 to be applicable. If any
notice under Massachusetts General Laws,Chapter 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.
MPIUA Claims Division
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