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Jones, Myrtle Form VS No. 62. • 10-20-44-1031 (4C-321) TRANSIT PERMIT NEW YORK STATE DEPARTMENT OF HEALTH ALBANY A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must ac- company each dead body transported by a common carrier.—Regulation 1, subdivision I. UNDERTAKER'S CERTIFICATE �11 ereb o.g rriifg that the accompanying dead body of Myrtle E.Jones a .k who died in the City of Utica (City, Village or Town) oi 3 46 Fema 7,17 _,_Single*daged .a County of Oneida , State of New York, on Nov• :.... 19 , Sex widowed i ivo Color or race V"dhitg , Age7..8 years 1Q..month 2...days, Birthplace E'.�,ir... m,Vela..., and Causeeed of Death Gm?.ra)- Arterl,Q-SCJ,,Q,roa,14, has been prepared for transportation , strictly i.i atwidauce with Reguladcin 1, subdivision ...13, as prnite with this blank. Certificate was signed by --—4— - F,.N.Burke M.D. Address -Zste of shipment NOV.� --- U t i�a.�.......r... p ''�s ..0 19 4PRoute of shipment Railway Express ; Point of Utica N. Y. Glens Falls N. Y. .�' shipment � ; Point of destination � d T. (Signature of Undertaker) 3 Dated November 3,� 19 46 Address Utica, N. Y. p, *Cross out words not applying. a PERMIT OF LO CAL REGISTRAR DIST. No. 3211 Registered No. / rJ Date of issuance NQY.ember 3, 19 46 A satisfactory Certificate of Death for above decedent havin en fled and orded ' my office, PERMISSION IS HEREBY GRANTED FOR THE REMOVA HIPM N THE DY. (Si ature of Loc 1 ar) Local Registrar of the of.... .. , County 1 (City, i age Town) State of New York. Only the Local Registrar(Deputy or Subregstrar)may 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 PER SON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE Date of -f • - te was S.' v 19.. � Interment n) (Signed) . ��U Person in charge of -. ..� �"-Q.---- - (Name of Cemetery, 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 UNDERTAKEN 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. Duttes-nf undertaker.- -lit-each ease the undertaker,or Person-having_ehArep of tha rn,•pse,shall file the cer- tificte of death with the registrar of the district in which the death occurred and obtain a burial or removal permit prior to any disposition of the body. * * * The undertaker shall deliver the burial permit to the person in charge of the place o ----�- burial, before 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 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 neces- sary details upon the form prescribed by the commissioner of health. § 381. Interments. No person in charge of any premises on which intermnts 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 hit; 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 lie enforced. Local Registrars are required, under penalty, to report violations thereof. Form VS No. 62. 10-20-44-10M (4C-321) TRANSIT PERMIT NEW YORK STATE DEPARTMENT OF HEALTH ALBANY [1( i' A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must ac- company each dead body transported by a common carrier.—Regulation 1, subdivision 1. UNDERTAKER'S CERTIFICATE i (4erebg filertifg that the accompanying dead body of Myrtle E.Jones a .x who died in the City of Utica (City, Village or Town) • =o County of Oneida , State of New York, on NOV. 32... 1946 , Sex Female u'Single ued Widowed Color or race Whit$ , ARES years 10...month 2...days, Birthplace '.a.ir...Ea.yala.., and Causeeof 1.3 4 Death GQ a '.a J- 4 :.r e ' -.Q^$C .Q '.Q$,. . has been prepared for transportation -_ i_ w stri...Lly inm� dan ce with Re 1ITc2Str a i"'"subdivisron 2.�..� as printecl ith t�`ils trak. - ertl c e was signed ii by - -----4" - E,,N,Burke , M.D., Address Utica, N. -4ite of shipment NOV. 3., 0 19 4�Route of shipment Railway Express ; Point of to Utica, N. Y. Glens Falls, N. Y. 4' shipment ; Point of destination m .e (Signature of Undertaker) 3 Dated November 3, 19 46 Address Utica, N. Y. p, *Cross out words not applying. 4 Q PERMIT OF LOCAL REGISTRAR DIST. No. 3211 Registered No. /7 Date of issuance November 3.., 19 46 A satisfactory Certificate of Death for above decedent havin en fled and orded ' my office, PERMISSION IS HEREBY GRANTED FOR THE REMOVA HIPM N THE DY. (Si nature of Loc i ar) Local Registrar of the of..._ County (City, i age Town) State of New York. Only the Local Registrar(Deputy or Subregstrar)may issue a Burial,Removal or Transit Permit fitsp 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 . � was 19 nterment o • n) c/ j (Signed) - ^ C Person in charge of •- �--^^C�`�" � ---'�``'� - (Name of Cemetery, 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 UNDERTAKEN 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. nutter-6-f undertake.- 4n eaeh ease the undertaker,or Person-b .uing rso of this rorpse.—shall file the cer- tificte of death with the registrar of the district in which the death occurred and obtain a burial or removal permit prior to any disposition of the body. * * * The undertaker shall deliver the burial permit to the person in charge of the place of --tea burial, before 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 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 neces- sary details upon the form prescribed by the commissioner of health. § 381. Interments. No person in charge of any premises on which intermgnts 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. uF" 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 l'se enforced. Local Registrars are required, under penalty, to report violations thereof. Form VS 67. NEW YORK STATE DEPARTMENT OF HEALTH ALBANY UNDERTAKER ' S REQUEST TO DISINTER BODY re See Special Administrative Regulation 1, subdivision 4, Relating to the Trans- portation of Dead bodies by Common Carriers, as printed on the back of TRANSIT LABEL. N. B. Permission for disinterment must ALWAYS be obtained whether the Body disinterred is to be transported by Common Carrier or by other means. I HEREBY REQUESTdeo--e#_ PERMISSION TO DISINTER the dead body of da , , who died in the* (City, Villag , Town) of at...... .. . .. . . . on* d �,/ yG , Sex..Ki1/dam , 4./ `� v �,yo Color or race* `�Y' , Age* wyeacs, and Cause of Death* NOW INTERRED IN..�w�r�-uv--cee-v (a) The body is to be TRANSPORTED BY COMMON CARRIER for at (State fully the disposition to be made of body) (Name of place or cemetery) (b) The body is NOT to be tra sport sported by Common Carrier but is tobe .c� at.. • , 4.4,0 ate fully the disposi on to be made of lwty) (Name of p ce or cemetery) I (Signature of undertaker) .....L ... .. ... ... .`''� Dated 7ifau-e4 a2 r 19�f4. Address A o License No ? 2 3, APPROVAL OF HEALTH OFFICER Dist. No. I HEREBY APPROVE above Request and recommend that Permission be granted. (Signature of Health Officer) Dated a a 19.5L.. Instructions to Local Registrar: Fill out (a) Transit Permit for bodies trans- ported by Common Carrier or (b) ordinary Offical Burial (or Removal) Permit for bodies not to be so transported, in each case writing the word"DISINTERMENT"on the Permit. The data required concerning the decedent may be filled in from the local register or cemetery record. When data can not be obtained write "Unknown" in spaces in- dicated by (*). The Disinterment blank should be filed and carefully preserved in your office.