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Seelye, Elwyn 4-13-16-10,000 TRANSIT PERMIT Form VS No.62 NEW YORK STATE DEPARTMENT OF HEALTH ALBANY Eff" A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead body transported by a common carrier.—Rule 1. .k1 UNDERTAKER'S XERTIFICATE ,Q 11berebp certif2 that the accompanying dead body of An,/ MZ70 R_ 0 who died in the of.__J..Y` OK� ,� /l (city,vin '' pI 'C County of .. - -- -- , State of New York,on i i9 j, ex il'A z— ,, • Color or ra Age 7,3 years — months days,and Cause of • 3 Death �� has been prepared for tr nspo • S strictly in accordance with RULE as printed with this blank.k. Date of sh ment .4 (State number of Ru �� 19i?Q_, Rou shipment 1__ ..w t �" t�� Point of � /. o shipment Point of destinatio. p�—� � 3 a (Signature of Undertaker) ro7 Dated e ' -f n 19 6. Address--__ %-- 3 PERMIT OF LOCA REGISTRAR � Dist. No. 6930 Registered No. .02 Date of issuance -4/7 f4.071rf« r . A satisfactory Certificate of Death for above decedent having been filed and recorded in office, PERMISSION IS HEREBY GRANTED FOR THE REMOVAL AND SHIPMENT OF THE B ' / (Signature of Local Registrar) 1 4, Local Registrar of the ll �`s,�/ 0$A,$:11-NGS...p-t�L..►i1J_RS-Qtst;.,�Colipty of ` /f! , (City, Village o own) State of New York. Only the Local Registrar (Deputy or Subregistrar) can issue a Burial, Removal or Transit Permit Detach here and give part above to escort or attach to waybill if shipped by express ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE Date of C2 _was � I IgainP (Inter ent or cremation, (Signed) �7 Person in charge of (?: ,,e/rdef,„ afr"It'A ___ .. 4 (Name of Cemetery, Crematorium, et Person in charge must return this Permit to Registrar of his District within SEVE ) DAYS from above date. If Ifo person is in charge,the UNDERTAKER MUST SIGN ABOVE STATEMENT,write across the face of the Permit the words"No person in charge," and FILE PERMIT WITHIN THREE (3) DAYS with Registrar of District in which cemetery is located. EXTRACTS FROM LAWS OF Ig13i CHAPTER 619, ARTICLE so § 379. Duties of undertaker. In each case the undertaker, or person having charge of the corpse, shall file the certificate of ,„r death with the,registrar of the district in which the death_occurred and obtain a burial or removal-permitprior than-disposition of-the body. * * * The undertaker shall deliver the burial permit to the person in charge of the place of burial,before interring or other- wise disposing of the body;or shall attach the removal permit to the box containing the corpse, when shipped by any transportation company; said permit to accompany the corpse to its destination,where,if within the state of New,York,it shall be delivered to the person in charge of the place of burial § 380. Duties of undertakers;interment within the state. If the interment,or other disposition of the body is to be made within the state, the wording of the burial or removal permit may be limited to a statement by the registrar, and over his signature,that a satisfactory certificate of death,having been filed with him,as required by law,permission is granted to inter, remove or dispose other- wise of the body, stating the name,age, sex,cause of death,and other necessary details upon the form prescribed by the commissioner of health. § 381. Interments. No person in charge of any premises on which interments or cremations are made shall inter or permit the interment or other disposition of any body unless it is accompanied by a burial,cremation or transit permit, as herein provided. Such person shall endorse upon the permit, the date of interment, or cremation,over his signature, and shall return all permits so endorsed to the registrar of his district within seven days from the date of interment or cremation. He shall keep a record of all bodies interred or otherwise disposed of on the premises under his charge,in each case stating the name of each deceased person,place of death, date of burial or disposal, and name and address of the undertaker;which record shall at all times be open to official inspection, provided that the undertaker or person having charge of the corpse, when burying a body in a cemetery or burial ground having no person in charge, shall sign the burial or removal permit, giving the date of burial, and shall write across the face of the permit the words, "No person in charge,"and file the burial or removal permit within three days with the registrar of the district in which the cemetery is located. SEXTONS and UNDERTAKERS violating the law relative to the return of permits are liable to a penalty of NOT LESS THAN FIVE DOLLARS NOR MORE THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The law will be enforced. Local Registrars are required,under penalty,to report violations thereof.