Loading...
Magram, William arm®B.U. NEW YORK STATE DEYAKTMLIYr ur Hica L i ri . OFFICIAL BURIAL (OR REMOVAL) PERMIT Q This Permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Primary Registration District (Town, Waage, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE OF EATH, LEGIBLY WRITTEN IN DURABLE BLACK INK Town Registered No_.... ,`� .........__ Village . r.tt .,' , li: il' ist. No f / County..._./ ...f.t.'t.. 4— or VCity illage �/� (If city, give street address) 'ame of deceased ��..r1,2 '7- ' - 7 '0'& ! Veteran ZLs / Single, married, wido ed, OE veteran, give name of War) ex..)7..g4.Color,C� k ..or divorced (wnte the word)./.�,r... Date of Death. l .19.5>3 ge .S . ....Year � Mo s , �,1..Da s Birthplace .. � ,•• •. •� ause of Death .,?r�r .. �Y�� A.?.?zr' y ertificate was signed by .. M.D. Address. .' ,..,),2 lace of Burial (Qr Removal) .. � ., J2.7. f body is to be tembtarily he}d,Lill 1n pa later) ;emetery i�--6"-4-Z. r-z! Date of Burial / .„."/? 19.4•-,3 f body is to be temporarily held,fill in pace later) ha Certificate of Death containing the above stated particulars, having been presented to me, after careful exami- ation, the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, have aeon ted the same for registration, have recorded it in my Local Record with the above stated Registered {umber, /the basiisthetireof I HE 2EBY, RANT A PERMIT ,' ;.1 ‘..y. 9. • ?ame) r "' (Address) le rt.a :•�-a-r —`'`-, to hold ten pora ' and the body. (Undertaker or pit having charge of corpse) �! d' (Inter, • oth mole of state how)) )rise}' .1.a:. ...d./ 19. 1".,3 (Signed) \ 'I.�C : .. .k., This Permit is sufficient for the Removal (and Interment er�Cr oration) of body to a y part o the State (+subject to local emetery or other regulations),unless removal is by common carrier, n which cam a Transit ermit (VS No. 62) is required. PREMISES ON WHICH INTERMENTS OR _ 0. , C MATIONS ARE MADE Date of V����"� was- �R�„__12.: 19 ( n ur, emation) 4,sryt+ meelsk (Name of Cemetery,Crema rium, etc.) Section Lot No. Grave No. (Signed) ii'!—.) - (Person in charge) 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 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 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 any registrar until, wherever practicable, a complete and satisfactory certificate of death has been filed with him as heretofore provided; * * *. 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 la,_No registrar of.vital.statistics •shall receive any fee for the'issuance . juar'rior removal permits under this act other than the compensation provided '; this article. Provided, however, that the state commissioner of health shall hav €'sower to promulgate rules with reference to the removal of bodies of persons w =se deaths occur on trains, boats or other carriers engaged in the transportation•' persons within this state. § 379. Duties of undertaker. In;%. ' h case the undertaker, or person having charge of the corpse, shall file the cer .to of death with the registrar of the dis- trict in which the death occurred%an«, a ai0•`a burial or removal permit prior to any disposition of the body. * * * T ' dertaker shall deliver the burial permit to the person in charge of the place o .. a t nterring or otherwise dispos- ing of the body; or shall attach the al' lit to the box containing the corpse, when shipped by any transpottatiofi coni any 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 inter- ments or cremations are made shall inter or permit the interment or other dispo- sition of any body unless it is accompanied by a burial,cremation or transit permit, ax,her4 lA‘ndosse,gritttilivgwevrnit, theelate-of inter- ment, 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 cre- mation. He shall keep a record of all bodies'int rred or otherwise disposed of on the premises under his charge, in each case'starting 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 tint be open to official inspection; provided that the undertaker or person having ch ge-,of the corpse, when burying a body in a cemetery or burial ground:having 'person in charge, shall sign the burial or removal permit, giving the date of b l "anti shall write across the face of the permit the words `No person ch. rarg ,=and file the burial or removal permit within three days with the registrar of th istrict in which the cemetery is located. SEXTONS and UNDERTAKERS violating the law relative to the return of per- mits 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.