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Barber, Bessie 8-14-30-10,000(17-1226) TRANSIT PERMIT Form VS No.62 NEW YORK STATE DEPARTMENT OF HEALTH ALBANY t 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. AI UNDERTAKER'S RTIFIC E =' u e A I 'lderebg dertitg that the accompanying dead body of _ ---•-- ,m l who died in the of - - \ ,�J (City,Village , '\Toown) g Singles 7 County of �'! -/ ��i2�L ,State of New York,on. �� ��""'► 19 1__,Sexy Married- - piyorced 3 Color or /--years...✓_months 1-"" days, Birthplac _ and Cause of >, Death L—4„ has been prepared for transportation 3 strictly in accordance with RULE Y as printed with this blank. Certificate was signed by �� (State number of yyy-) A -• (� ,� M.D., Address L- GLe ate of shipment' wd �_••-� --- -- 6�" 19 Rou,Lem$shipment ; Point of ashipment .--��/ - � y''Point of dest ation .2� e (Signature of Undertaker) Dated L � 19 *Cross out words Addrnot applying. ' . -c :- , PERMIT OF LOCAL REGISTRAR r Dist. No. / r l F 4 Register No C>Li Date of issuance Sa DV" 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 $D 1 ' _/` (Signature f Local Registrar) t/I v Local Registrar of the of- -, County 6tr_ (City,Village or Town) r State of New York. ' Only the Local Registrar (Deputy or Subregistrar) may issue a Burial, Removal or Transit Permit r tar Detach here and give part above to - o waybifl if-Shipped by express r. __— .._.__ — -- �r Attach part below to outer box or case TRANSIT LABEL Form VS No.62 NEW YORK STATE DEPARTMENT OF HEALTH ALBANY 0 A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead body transported by common carrier.—Rule 1. ll PERMIT OF LOCAL REGISTRAR �v Dist No =1 Registe ed No jr—. Date of issuance - A satisfactory Certificate of Death having been filed and record in y office for. -- -` --- ----------_.-_-- _-- ..`��,,_,l , who died in the / (City, Village Town) County of__./ ....t_._ , State of New York, on , the body;having.bee prepared strictly in accordance with RULE , as certified by !/t/ (Name and 0 Shipping Undertaker, PER MISSION ISBY GRANTE es is of hipping Undertaker) i a i T; Name of escort '� R THE RE OVA D SHIPMEN OF THE BODY OF SAID D ,.e . ,consignee 47-.4".7.-ilk P ' t of ; Point of Shipment Destination '�. 't .' »7 �� • :.• ,5." (Sign 't � of cal Registrar - M el-4Let ,County of / Q • Local Registrar of theof - (City,Village or own) • State of New York. 3 to , ROUTING 3 The Railroad or other Transportation Agent must enter hereon a description of the ticket held by the passenger in charge ,d of the corpse, the exact route,and VIA WHAT JUNCTIONAL POINTS it reads. hSPECIAL INSTRUCTIONS—A burial case containing a corpse must not be received f or transportation unless the person in charge presents a Transit Permit issued by the Local Registrar of Vital Statistics (Rule r), and an Undertaker's Certificate stating that the body has been prepared for shipment in accordance with the Laws of the State;nor should it be received even then if any fluids or offensive odors are escaping from the case. Date 19 From State of New York,to State of No.of Escort's Ticket Form No. of Escort's Ticket No.of Corpse Ticket Form No.of Corpse Ticket Via To Via- To Via To Name of Passenger in charge Place of Residence Signed Shipping Agent ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE Date of r9-was 1 (Interment of cremation) (Signed) Person in charge of (Name of Cemetery, 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 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 burial,before interring or other- wise disposing of the body; or shall attach the burial permit to the box containing the corpse, when shipped by any transportation company;said permit to accompany said 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. agr 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. NEW YORK STATE DEPARTMENT OF HEALTH ALBANY SPECIAL ADMINISTRATIVE RULES RELATING TO THE TRANSPORTATION OF DEAD BODIES BY COMMON CARRIERS [In effect throughout the State of New York,except in the City of New York,on August i, 19r5] RULE- ,A,transit. �nFl-�iab'el7sstied by the Iocafregistrar of vital statistics must accompany each dead body trans- ported by a common carrier. The transit permit shall state the date of issuance, the name, sex, race and age of the deceased, and the cause and date of death. The transit permit shall also state the date and route of shipment, the point of shipment and destination, the method of preparation of the body, and shall bear the signature of the undertaker and the signature and official title of the officer issuing the permit. The transit label shall state the date of issuance, the name of the deceased, the place and date of death, the name of the escort or consignee, the point of shipment and destination; and shall bear the signature and official title of the officer who issued the transit permit. The transit label shall be attached to the outer box or case. RULE 2. The transportation by common carriers of bodies dead of any diseases other than those mentioned in Rule 3 shall be permitted only under the following conditions: (a) The coffin or casket shall be encased in a strong outer box made of good sound lumber,not less than s of an inch thick. All joints shall be securely put together and the box tightly closed. Either the coffin or casket, or the outer box or case, shall be watertight. (b) When the destination cannot be reached within 6o hours after death, all body orifices shall be closed with absorbent cotton,and the body placed at once in a coffin or casket which shall be immediately closed and the coffin or casket shall be encased in a strong outer box made of good sound lumber not less than s of an inch thick. All joints must be securely put together and the box tightly closed, and either the coffin or casket, or the outer box or case, shall be watertight. RULE 3. The transportation by common carrier of bodies dead of smallpox, plague, Asiatic cholera, typhus fever, diphtheria (membranous croup, diphtheritic sore throat), scarlet fever (scarlet rash, scarlatina), shall be permitted only under the following con- ditions: All body orifices shall be closed with absorbent cotton, the body shall be enveloped in a sheet saturated with an effective disinfecting fluid and shall be placed at once in a coffin which shall be immediately and permanently closed. The coffin or casket shall be encased in a strong outer box made of good sound lumber,not less than s' of an inch thick,all joints of which shall be securely put together and the box shall be tightly and permanently closed. Either the coffin or casket,or the outer box or case, shall be watertight. RULE 4. No dead body shall be disinterred for transportation by common carrier without the previous consent of authorities having jurisdiction at the place of disinterment. The transit permit and transit label shall be required as provided in Rule I, and Paragraph (a) of Rule 2 shall apply. RULE 5. Every outside case holding any dead body offered for transportation by common carrier shall bear at least four handles and when over 5 feet 6 inches in length,shall bear six handles.