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Seems, Frank Form VS.6L NEW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT tar 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 CERTIFICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Town is No... ... .... .... Village Dist. Ni "Z6 County or City u (If city,give street sears Name of deceased... Veteran lri le married WidOWed G loran, give name of War) U //,�,� o Se .. Color . .. r divorced (writ a word}lit%/ ifYl(/ . .... .Date o ©.c 19.�,�.�'. Age Y /2' Months a plot. Cause of Death.G ... dXr„ . Certificate was si d -- Address Place of Burial tt. emov 1 .. ,. (If body is to b`te,f r my r) '' spa Cemete Date of Bur' a, 19.1( (If body is to be temporarily d,fill In space later) The Certificate of D containing the above stated particulars, having been pr s ted t e, after careful exami- nation, the same appearin: to be COMPLETE, CORRECT, AND SATISTACT RY AS REQUIRED BY LAW, I have pt the same or registrat..4 , have r- , -. it ' y o I Record ith the above ted Registered Nu a s' �, 1 I tr REBY i A .�,... to... / / r �!. • the ..� 1 ' ' ...to hold temporari t ody. (1 . • r�. reon 7 eying charge se) v oth r ise o stet o Dated ,) 19.., (Signed) CV Local Re This •ermit is /fficient for the Removal (and Interment or Cremation) of a body to any past of the State (sa pact to local cemetery or other reeulationa).unless removal is by common carrier. in which eaaP_ a Trenait Permit (VS No. 62) is required. ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS OR CREMATIONS ARE AD Date of rt"41( 19 l....{ (Interment zit crema n) (Signed) f1f/( ...... ... (Person in charge) (Name of Cemete :rematorium, etc:) tr 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 UNDER- TAKER 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 OF THE VITAL STATISTICS LAW § 375. 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 an) registration district,or be temporarily held pending further disposition more than seventy-two hours after death unless a permit for burial, removal, or other disposition thereof shall have been properly issued by the registrar of vital statistics of the registration district in which the death occurred or the body was found. No such burial or removal permit shall be issued by ally registrar until, wherever practicable, a complete and satisfactory certificate of death has been filed with him as heretofore pro- vided; provided that when a dead body is transported from outside of the state into a registration district in this state'for burial, the transit or removal permit issued in accordance 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 herein provided for. No registrar of vital statistics shall receive any fee for the issuance of burial or removal permits under this act other than the compensation provided in this article.* Provided, however, that the commissioner of health shall have power to promulgate 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 this 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 registrar of the district in which the death occurred and obtain a burial or removal permit prior to any dicpositi‘in of the body.*** The undertaker shall deliver the burial permit to the person in charge of the place of 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 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 oi;the place of burial. § 381. Interments. No person in charge of any premises on which interments or cremations ate made shall inter or permit the interment or other disposition d''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 crematyllbn 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 recordrecord--frf all bodies interred or otherwise disposed of on the premises under his charge, in each ease 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 tifficial inspec- tion;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. gv 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 reauired. under penalty. to report violations thereof.