Daniels, Tuffle Permit for Burial, Entombment or Removal.
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Issued to • 6Z9-'4-4-4-- -***--fr. .. No.
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4 County of _-__ _ STATE OF VERMONT.
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a1111SP i Town or City of i Permit for Burial, Entombment or Removal.
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p.
Date of Death- f 192
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F Full Name Age Q
, /� fears Months nay',
• g Disease causi g death ® l� •411-1 2� '����
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• x Medical attendant t /-- -
w w Proposed date of burial, entombment or removal ►92 4--
CdProposed place of burial or ento nt -?--,-.-----
ct a Proposed place of removal_ W --
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zz 't Manner of burial, entombment or removal __- O
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Undertaker _ . #t . - — ► +�
/ Address
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w A Certificate of Death (or removal or trar .- ' ) having bee fled in my office in
a
z accordance with law, I hereby authorize th- _ - - _of the body of said
G [Burial,entombment or emoval]C
x deceased:T° :
n stated0.
�� Town Jerk.
Date _ 192
This permit, if p � •�, y made and signed, is authority for the burial or entombment in any cemetery or tomb in this State.
i
BURIAL AND DISINTERMENT OF DEAD BODIES
BURIAL PERMIT No.61 Acts of 1923. The town clerk of each town shall
receive all certificates,of deaths occurring within his own
FOR town, and shall issue,llurial permits and receive fees there-
for as provided by sections 3801, 3808, 3811, 3812, 3813,
3814, 3818, 3819 and 3820 of the General Laws; provided
that burial permits in cases of deaths from communicable
c / diseases shall not be issued by a town clerk except in ac-
cordance with instructions to be issued by the local health
Filed------------------ �., 7/ 19 7-0- officer or the state board of health and to be kept on file
by the town clerk.
Sec. 3801. Certificate of permission required. A dead
INSTRUCTIONS.—This permit must be elelivered to the body of a human being shall not be buried, entombed or
Clerk of the town or city in which the burial or entomb- removed from'a town, or otherwise disposed of, without
anent is made during the first week of the month following a certificate of permission issued and signed as hereinafter
such burial or entombment. provided, by the health officer or deputy health officer and,
in case of their absence, by the town clerk.
--- ------ ------- - Sec. 3809. Burialermit. If it is desired to bury, en-
:Y I to tomb or otherwise dispose of a dead body within the limits
of a town where the death occured, the certificate of per-
�. <' mission shall state plainly the time, pl a and manner of
oo�- \ F -, such burial, entombment or dispositiol[; and, if it is de-
�\ b, t 0 L sired to remove a dead body from the town where the
o. �I death occured, the certificate of perry scion shall contain
ro
Cr ro 1 the essential facts contained in the ce~t ificate of death on
a °w on which is was issued, and shall accompany the body to its
t' sa destination, and may be accepted as a permit for burial
to 1
ro r or entombment by a sexton or other person having the
�, 2 n , care of a cemetery,burial ground, ton or receiving vault.
w' C,:. Sec. 3810. Unauthorized burial or.. removal; penalty.
y d_ , A. g \3 - 4"' N\ A person who buries, entombs, transports or removes the
. �0��,� ?- v a ' dead body of a human being without h certificate of per-
w' co '- ' u ►-1 mission.so to do, or in any other manner or at any other
o x -* , 7 time or place than as specified in such certificate, shall be
m °: '4 it � q I imprisoned not more than one year or fined not more than
.-,\.� 7,- five hundred dollars nor less than ten dollars, or both.
o,1 \
?! it ► !�- Removal of Dead Bodies.
R I �" N. pQ Sec. 3811. Permit. A person desirious of disinterring
w o 1i; \ or removing the body of a human being from one cemetery
J\ 1 1, o ar 1 to another cemetery or to another part of the same ceme-
0 a ` 1' ``�.\ I fD tery or from a tomb or receiving vault elsewhere, shall
w \ `D �'� I first obtain a written permit from the health officer, if
F it :46- , C there is one, otherwise from the board of'health of the
j ` - town where such dead body is interrdd or entombed.
,, - Duties of Sextons.
m , \ 04 4,\ Sec. 3815. No burial or removal Without permit. A
" �• ' sexton or other person having the enre of a cemetery,
$ t , ` I. y ,�:7 tomb or�receiving vault shall not receive or permit the
► °" I burial or entombment of a dead body, or the remains
' k, \ thereof, in the cemetery or tomb of which he has charge,
1 'kk kk or the removal of a body therefrom, until there is deliver-
- ‘\ h k h, ' ed to him a certificate of permission issued in accordance
0with the provisions of this chapter.
r k Sec. 3816. Returns. A sexton or other person having
�� ; I 1.. ` charge of a cemetery, tomb or receiving vault shall, dur-
big the first week of each month, deliver to the clerk of
m `` k, the town in which such cemetery, tomb or vault is located,
1 \••_,Jr \1 the certificates of permission for burial, entombment or
m .. I ` removal, properly certified, which he received during the
1 1 .1 ,` ' CD co preceding month.
•,, ` \ I Sec. 3817. Penalty. �A sexton or other person having
charge of a cemetery,tomb or receiving vault who violates
1 a provision of the two preceding sections shall be fined not
t
more than five hundred dollars not less than twenty dol-
lars.