Loading...
Kapetan, Baby boy Form VS.Si. r EW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT to This Permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Primary Registration District (Town, Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERT E OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. zat i ed No.... Dist. Nc ../County.... / y< lei"4: City (If city, give street address) Name of deceased Veteran.. .. .... ...... yy� Single, arried, w' wed, (If veteran, give name of War) Sex. �I" Color.. or div ced (writ e w Date of D �� /39 .t ,1. Age s ... }� Bi place....r.���'t�e"7���� a Cause of Death --� Certificate was signed . M.D. Address / Place of Burial ( Remeoiv l) •r (If body is to be to r11y eld, ti11 in space I ter) Cemetery Date of Buria ;t/ 19 7(If body is to be temporarily held, till in space later) The Certificate of Death cJataining the above stated particulars, having been presented to me, after careful exami- nation, the ame ax 1-,t-,rir g tf. b COMPLETE CORRECT, AND: SATISFACTORY AS U "ED BY LAW, m I have ac ed the sae f # Mxstration, r orded it in my Loca ec with th abo to Re istered Number on the b eof i I-7 " RANT A PERMIT it.;i (N Add as) the . .. . . .... .. .... to hold temporarily n .. ....... .. .. .. .. .. . . ! 1 e body. Ili - or rrjon R arg se) a ve, r oth wi s , e ,�J Datedi.. nr o�.19 (Signed) Local Registrar This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (su.ject to local cemetery or other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required. ENDORSLMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE MADE Date of.„. ......' ---74- ,.21•-• .107 (int rm,........;,/,,,,, i / (Signed (Person .X40‘i in charge) . .....e.4..44.&. .... .. .. .. ... (Name of Cemetery, (..rematorium, (7.) at Person In charge must return 'his Permit to Registrar of his District with SEVEN (7) DAYS from above date. If no person is in charge, the UNDER- TAKER MUST SIGN ABOVE STATEMENT, write across the Lace of the Permit the words "No person in charge," and FILE PERmi-r WITIHIN THREE (3) DAYS with Registrar of District in which cemetery is located. EXTRACTS OF THE VITAL STATISTICS LAW § 379. Permits for burial or removal of dead bodies. The body of any person whose death occurs in this state or which shall be found dead therein shall not be interred, deposited in a vault or tomb, cremated or otherwise disposed of or removed from or into any registration district,or be temporarily held pending further disposition more than seventy-two hours after death unless a permit for burial, removal, or other ii disposition thereof shall have been properly issued by the registrar if vital statistics of the registiation district in which the death occurred or the body w s found. No such burial or removal permit shall be issued by any registrar until, wh rever practicable, a complete and satisfactory certificate of death has been filed with hirr as heretofore pro- vided; provided that when a dead body is transported from outside!of the state into a refristration district in this state for burial, the transit or removal permit issued in ac'cordance with the law and health regulations of the place where the death occurred shall be given the same force and effect as the burial permit liereint provided for. No registrar of vital statistics shall receive any fee for the issuance ol burial or removal tyrmitsunder this act other than the compensation provided in this irticle.* Provided, however, that the commissioner of health shall have power to or iulgate rules with reference to the removal of bodies of persons whose deaths occur on trains, boats or other carriers engaged in the transportation of persons within thi state. (Am'd by L. 1932, ch.267.) , •See section 390. •§ 379. Duties•of undertaker. In each case the undertaker or person having charge.of the corpse,shall file the certificate of death with the registr r of the district in which the death occurred and obtain a burial or removal permit prio to any disposition of the body.*** The undertaker shall deliver the burial permit to t e person in charge of the place of burial, before interring or otherwise disposing of he body; or shall attach the removal permit to the box containing the corpse, when sh,pped by any trans- portation 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. § 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, its each case Stating the name of each deceased person, place of death, date of burial or isposal,and name and address of the undertaker;which record shall at all times be ope,to official inspec- tion;provided that the undertaker or person having charge of the co pse,when burying a body in a cemetery or burial ground having no person in charge, s all sign the burial or removal.permit, giving the date of burial, and shall write acro s the face of the permit the words "No person in charge," and file the burial or rem val permit within three days with the registrar of the district in which the cemetery is ocated. t0 SEXTONS and UNDERTAKERS violating the law relativ to the return of pevrnits 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.