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MASSACHUSETTS PROPERTY INSURANCE UNDERWRITING ASSOCIATION
Two Center Plaza
Boston,Massachusetts 02108-1904
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(617)723-3800 Ma Only(800)392-6108,FAX(800)851-8424
1._ .._.. 3/7/2026
Form of Notice of Casualty Loss to Building
Under Mass. Gen. Laws,Ch.139,Sec.3B
YARMOUTH BUILDING DEPT
1146 ROUTE 28
SOUTH YARMOUTH MA 02664
Re: Insured: JOSEPH BORNSTEIN&EILEEN KAVALL
Property Address: 184 SOUTH SEA AVENUE UNIT 28,WEST YARMOUTH, MA 02673
Policy Number: 1081632
Type Loss: Windstorm Other than Hurricane or Tornad
Date of Loss: 02/28/2026
Claim Number: 491155
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
CMA00021