Dufour, David 8-29-36-10,000 (17-1824)
Form VS No.62.
TRANSIT PERMIT
NEW YORK
STATE DEPARTMENT OF HEALTH
ALBANY
g A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each
dead body transported by a common carrier.—Regulation 1, subdivision 1.
UNDERTAKER'S CERTIFICATE
• 3 lirrebp (nerttfp that the accompanying dead body of David Dufour
.x who died in the TQW I of Marcy
d _. ('City,Village or Town)
.0 „ Sin le*
'*it of_ ._..._:_ �ua�r State of New York, on Feb._ -,_ _19 46 Sex._ pVlale�_ _i` ? ided
fy' y � .._......_.„.,.._._._.___.., Widowed
White 74 0 ..a
17 i Divorced
( or race..._._.__._.........._........__...._.._....._, Age__..... ...years_.__....._._months_..._......_._days, Birthplace_.._...._.. au . ,.a.._..._.._._,_..__._, and Cause of
a
Di.ath...__......,.•.w__ Generalized Arteriosclerosis has been prepared for transportation
3 st.^tly in accordance with Regulation 1, subdivision_........_.2-A as printed with this blank. Certificate was signed by
Schwarz , M. D., Address hIare YIN.Y. Date of shipment_.__Feb.4.z.1946
Te Railway Express
,•zo . __; Route of shipment_ Point of
d shipment_._.......__..0 t c a s_..._.T'•....._y_'.__........_._._....; Point of destinat l e n 1 s '_.. . .._... 1 ....:_._..._....
3 (Signature of Unde4aker).. s 1V :. _:+A 11..._._., /I... ......___...
Dated
a.
February 4thtt 46 12 SteUb.Q. ..._. _-1 ..1c..�..,..._l'`.�_...x.._.__ ...._..._.._
W _ .. ..._...._.... ..._....____19 Address._....._.. E_ r..
3 *Cross out words not applying.
a PERMIT OF LOCAL REGISTRAR
Dist. No. r / Registered No.
Date of issuance Fe r1'a.r;L 4th, ._...._....19._46
A satisfactory Certificate of Death for above decedent having been filed and recorded in my office, PERMISSION IS
HEREBY GRANTED FOR THE REMOVAL AND SHIPMENT OF THE BODY.
.._ (Signature of Loc 1 Re_is+ ar) -4 — ='G-fl ..-- -d� ._.-._..__•-_.•-_-._.—
t� _
Local Registrar of the.._. i:._.._.._.._....:....__. 4e10.4,.i : , County of 4::._ ...- _._ ..._
(City,Vilia e or a(tica) /
State of New York.
Only the Local Registrar (Deputy or Subregistrar) may issue a Burial, Removal or Transit Permit
OF 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
eeet.,
Date of_.._..__.. __was....._..._... .......... 192
(Interment.or Cremation)
(Signed)-......_._.._.._...._...__ _____... _ __ ._.. ____C'
� r
Person in charge of....._._._._..._._.-...__
(Name of C etery, Crematorium, etc.)
Person in charge must return this Permit to Registrar of his District within SEVEN (7) DAYS from above date. If no 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 VITAL STATISTICS LAW
§ 379. Duties of undertaker. In each case the undertaker, or person having charge of the corpse, shall file the certificate of
—__death_with theeggistrar of the district in which the death occurrec a_nd obtain a_burial or removal permit prior_to_anw disposition
of the body. * * * The undertaker shall deliver the burial permit to the person in charge of the place of burial, befi,re interring
or otherwise 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 signa-
ture, 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 pre-
scribed 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 pro-
vided. 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.