Moore, Edward Forri VS No.61 -NERK
STATE DEPART OF HEALTH
AY
OFFICIAL BURIAL REMOVAL) PERMIT Re$istra�
is This Permit can be signed only by the Localrar(Deputy or Subregistrar)of the Primary
Don District (Town, Villa e, or City) in which the occurred after the FILING and
BLACKce of aCOR�
RECl AND P 10 _E E CERTIFICATE OF DEATHIBLY WRITTEN IN DU
Dist.N ._).; ._ ----
County_ Reg ter o.._.
{/ f pp
• __..,,____,..»..t._..( L D e of Deat
Town, Color. - -•...
- -
Vie.-/ . - rs.
( r sc o ____ ..
ut name not applies 1 ��� isillii4/7Cause of Dea�t� -
Place of Bur' -� � ---- 9
(or Removal) -- -- - -- ----- tery -- •-- ••-----------Date
uri.
A CERTIFICATE OF DEATH of _'
(Givefull name of e ased) UIRED BY
having been presented e Om contain' the abostated particulars,and,after careful examination,
the same aprearing to be COMPLETE,CCORRE', AND SATISFACTORY AS REQ
LAW,I have accepted the same for re zstratic have recor.ed it in my Local T A PERMIT
with
th ttedit7(km Rsgi red Nu ber,-anrrd//on is basis the ` EREBY- C
(Name of U derta r) (A the body.
the to o
( n itak or - of a ise dispos
- _ o state howl)
a charge of to (I n
Dated__ `f ""�
y�rp/fie ..__.--
•- - -- 19-'�-O to
.- $to any part of th•
strar
This Permit is sufficient for the Removal (anc Inter i b9
r • a eoznruon carrier,
State (subject • local cemetery or other regulati ;arid ,that here remora
the above Permit must be included in the TreIt.
N IN
2-9-24-20,000 (21-4144)
ENDORSEMENT OF SEXTON OR PERSO
s ARE MADE
CHARGE OF OR mATIoN_
‘-'
PREMISES ON WHICH INTER-
MENT .e.2.-...,
__
Date of...........
.-
ation)
7
(Signed)..
t
(Person 74......e.2,
f remeterY,Cr in charge)- (Na e°- - Re istrar of--1- IIDER-
'mit to g ha e the 13.
return this Pe is in c ig > Permit
charge must
If no person
atorium,etc.) D
Person in
bove date- write acres the face of
(3)
from above date.
istrict within
SEVEN(7) SIGN ABOVE STATEMEN ,
.
ERMIT WITHIN
FILE P
eorartnnaskaPe°,:d7arg .
DAYS
TAKER MUST . harp?and . eNofTtille
the words"No
of is
D. trict in which
in c
1.,*1.cemetery
DAYS with Registrar ----_
EXTRACTS FROM LAWS OF 1913'
of undertaker. In each c
certificate o .
Is located.
ndertaker, or
f deat wiregistrar
h th the ,
• . or removal
burial
ARTICLE 20p.erson
d nd obtam a
h occurre a * * The un
al, before
• charge of
hich the do of
§ 379. Duties corpse,
lace of bill- removal
having CHAPTER
E:the6iu9
the ig
of the district in shall file the
t.of
the it_orior t°.PY :t. to the Person l bady; 0.r remtasohat 11
w disposition of the bnodeiYia•r;of
within the state o-i'New York, it 'sla'ah be delivered to the place of burial. t.,t,ha t i at t payee hrdit the
e
§ 380. Duties of undertakers; interment within the state. If the inter-
ment,or other disposition of the body is to be made within the state,the word-
ing 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 otherwise 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 inteiment 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.
________
gligr-SEXTONS and UNDERTAKERS violating the law relative to the re-
turn 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.