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Kantrowitz, Sally FORM VS NO. 62 Attach part below to outer box or case 2-70-10M(B3-3) TRANSIT LABEL NEW YORK STATE DEPARTMENT OF HEALTH ALBANY A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead body transported by a common carrier. — San. Code Sec. 13.1 (a). 2700 PERMIT OF LOCAL REGISTRAR DIST. NO. Registered No. Date of issuance 10' _7A 19 Ka A satisfactory Certificate of Death having been filed and recorded in my office for Sally H. Tlt? ^.AIi fZ who died in the C tv of Rochester . Monroe (City, r own Y County of ,State of New York on Oct. 2, 19 7 , and u a ▪ the body havin been prepared strictly ,� c rdt e w San. Code Sec. 3.1, Par.A-2. ..�.. ,., as certified by • Parsky Plneral HCMe i.,z 5 with . t . Aoche ter, .', .Y n Shipping Funeral Director/Undertaker, PERMISSION IS HEREBY °• (Name and Address of Shipping Funeral Director/Undertaker) -o GRANTED FOR THE REMOVAL AND SHIPMENT OF THE BODY OF SAID DECEDENT; Name of escort or consignee ' ▪ S} 11vap & Min h.n Inc . ; Point of shipment. 3ocheFte1 , N. Y.. ,Vlens-rails, .- . >. Point of destination haarav„rpfi.i.a.. Cem...Q7, e .Falls, r'S.y ... _ • • • • •••a• .. a' (Signature of Local Registrar) i a Local Registrar of the V of ROCreSt' r , County of Mohr e , State of New York. (City, ROUTING The Railroad or other Transportation Agent must enter hereon a description of the tickets held bythe Q P 9 P passenger in charge of the corpse, the exact route, and VIA WHAT JUNCTIONAL POINT,it reads. SPECIAL INSTRUCTIONS—A burial case containing a corpse must not be received for transportation unless the Person in charge pre- !� sents a Transit Permit issued by the Local Registrar of Vital Statistics, and a Funeral Director's or an Undertakers 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. NO," STATE SANITARY CODE PART 13 TRANSPORTATION OF DEAD BODIES (Statutory authority: Public Health Law, § 225) Sec. 13.1 "Transportation of dead bodies by common carrier Section 13.1 Transportation of dead bodies by common carrier. The transportation of dead human bodies by common car- rier shall be conducted in such manner as not to be a menace to health and shall conform to the following requirements: (a) Transit permit and label required. A transit permit and label issued by the local registrar of vital statistics must ac- company each dead body transported by a common carrier. (1) 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 destina- tion, 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. (2) 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. (b) Transportation of bodies dead of other than enumerated diseases. The transportation by common carrier of bodies dead of any diseases other than those mentioned in subdivision (c) below shall be permitted only under the following conditions: (1) The body shall be encased in a sealed metal transfer shipping case or in a coffin or casket.The coffin or casket shall be encased in a strong outer box made of good sound lumber, not less than seven eighths of an inch thick, and all joints shall be securely put together and the box tightly closed. Either the coffin or casket, or the outer box or case, shall he watertight. When shipment is made by air, the coffin or casket may be encased in a sturdy plywood outer box or receptacle made of heavy water-repellent canvas or equivalent material,designed specifically for the purpose. Every out- side case holding any dead body offered for transportation by common carrier shall bear at least four handles and when over five feet six inches in length shall bear six handles. (2) When the destination cannot be reached within 60 hours after death, all body orifices shall be closed with absor- bent cotton and the body placed at once in a coffin or casket which shall be immediately closed and the coffin or casket shall be prepared as indicated in paragraph (1) of this subdivision. (c) Restrictions on transportation of bodies dead of enumerated diseases.The transportation by common carrier of bodies dead of smallpox, plague, Asiatic cholera, typhus fever, diphtheria (membranous croup, diptheritic sore throat), scarlet fever (scarlet rash, scarlatina), shall be permitted only under the following conditions: all body orifices shall be closed with abso- rbent cotton, the body shall be enveloped in a sheet saturated with an effective disinfecting fluid and shall be placed at onc in a coffin which shall be immediately and permanently closed. The coffin or casket shall be prepared as indicated in para- graph (1) of subdivision (b) of this section. (d) Restrictions on disinterment. (1) No dead bodies shall be disinterred for transportation by common carrier, or for re- moval to another cemetery in the same registration district, or in another district, but not requiring shipment by common carrier, without the previous consent of authorities having jurisdiction at the place of disinterment. (2) The undertaker shall make a request to disinter the body on a form provided for the purpose. This form shall pro- vide for a statement of principal facts concerning the decedent, whether body is to be transported by common carrier or otherwise and final disposition of same. Upon receipt of such request the local registrar shall issue a transit permit and transit label as required by subdivision (a) and the provisions of paragraph (1) of subdivision (b) shall apply. (e) Exceptions. Notwithstanding any other provisions of this section, dead human bodies, prepared for shipment by the War Department of the United States in accordance with the repatriation program, may be accepted by common carriers for shipment to places designated by that department. Under the authority of a basic health permit issued by the War Department the registrar of vital statistics of the district to which such a dead human body has been transported shall issue a permit for the burial, removal or other disposition of the dead body. The permit shall be made out as completely as possible on the basis of the information available. FORM VS NO. 62 2-70.10M(B3-31 TRANSIT PERMIT NEW YORK STATE DEPARTMENT OF HEALTH ALBANY !AV.. A Transit Permit and Transit Label issued by the Local Registrar of Vital Statistics must accompany each dead body transported by a common carrier. — San. Code Sec. 13.1 (a). CERTIFICATE OF FUNERAL DIRECTOR OR UNDERTAKER I Hereby Certify that the accompanying dead body of Sally R. Kantrow tz Veteran' no who died in the ''1ty of Rochester (If veteran,give name of War) (City, `4 e..aa.I wn) + r �wg1e County of ly+ol!3� Oe , State of New York, on Oct " ? • 19 .7.R..,Sex.f.ePIa�.p WidMowed Divorced Color or race White Age 7o years months days. Birthplace N.Y. and Cause of cardiac arrest v_ IDeath_-.-. . --- .-_-._...--._.-.....-�-z_. --«._-- T,c_.-- ----r.: - <,.- --- -___-has-been prepared-for transper:ation strictly in accordance with San. Code Sec. 13.1, Par... A-2 . as printed with thi blank. Certificate was signed by a Dr. aandi 225�j 5 Portland Ave. Aoch . . N.Y. c Bri M.D., Address Date of shipment..1.Qr.3.. -a 19 78 ; Route of shipment Allep'hany Airlines ; Point of 3 shipment Rochester, N.Y. ; Point of destination Shaaray Tefila Ce"' . Glens Falls , N.Y. T Sullivan & Minhan Inc. Glens Falls, N.Y. Name and Address of Consignee �y / ,/ tTp °� (Signature of Funeral Director/thnlertaf«,), (.€ '4 / �¢ t Reg. No. .a � ' / Dated �v� 19. ./a Address /! Z'? ...� .( �'d 7� 1: : `; *Cross out words not applying. T PERMIT OF LOCAL REGISTRAR 0 DIST. NO. 2700 Registered No. a Date of issuance 20-3-78 , 19 i A satisfactory Certificate of Death for above decedent having been fi a d recorded in my office. PERMISSION IS HEREBY GRANTED FOR THE REMOVAL AND SHIPMENT OF THE BOD . (Signature of Local Registrar) , .. . . City Rochester Monroe Local Registrar of the of , County of. .. , (City,Viiiagel-Pflwrr� State of New York. Only the Local Registrar (Deputy or Subregistrar) may issue a Burial, Removal or Transit Permit Or 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 (Interment or Cremation) (Name of Cemetery, Crematorium, etc.) Section Lot No Grave No Signature (Person in Charge) (Address) Persons 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 FUNERAL DIRECTOR OR 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. SEXTONS, FUNERAL DIRECTORS 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.