USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 13
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SECTION 4. (No undertaker shall bury the ashes of a human body which has been cremated until he has received front the person having the charge of the erematory a certificate that the burial permit and the certificate of the medical examiner prerequisite to the cremating ofsaid body have been duly presented.
SECTION 5. Ahy person violating the provisions of either of the four preceding sections shall forfeit not exceeding fifty dollars. SECTION 6. No railroad corporation or other common carrier omperson shall convey or canse to be conveyed, through or from any city or town in this Commonwealth, the remains of any person who has died of small-pox, scarlet fever, diphtheria or typhus fever, until such body has been so encased and prepared as to preelude any danger of communicating the disease to others by its transportation ; and no city or town clerk, or clerk or agent of the board of health, shall give a permit for the removal of such body until he has received from the board of health of the city or from the selectmen of the town where the death occurred a certificate stating the cause of death, and that said body has been prepared in the manner set forth in this section, which certificate shall be delivered to the agent or person who receives the body. . Any person violating the provisions of this section shall forfeit not exceeding twenty-five dollars.
SECTION 7. The boards of health of cities and towns shall. on.d before the first day of. May in each year, license a suitable number of undertakers who can read and write the English language, to take charge of the funeral rites preliminary to the interment, removal or eremation of a human body. Such Lenses shall be issued nuder such terms and upon such conditions as the board of health may prescribe. and may be revoked at a time by the board when such terms or conditions or any requirements of law relative thereto have been violated by the nnertaker : provided, however, that an undertaker so licensed shall have the right to act thereunder in any city or town in the Commonwealthi.
Acts of 1897, Chap. 444, Sect. 10.
A physician who has attended a person during his last illness shall fort with, after the death of said person, furnish for registration at the request of a duly lieen undertaker or other authorized person, or any member of the family of such deceased person, a certificate, stating to the best of his Nowledge and belief the name of the deceased, his supposed age, the disease of which he died, the duration of his last sickness, and the darf his decease ; and a physician who has attended at the birth of a child dying immediately thereafter, or a physician or midwife who hak attended at the birth of a child born dead, shall forthwith furnish for registration a certificate stating that to the best of his or her knowledgeand belief such child either died immediately after birth or was born dead.
A physician or midwife who negleets or refuses to make the certificate required by this section or who makes a false statement therein shall forfeit not exceeding fifty dollars.
Pearl avenue
George Nourley
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Statta Chapin Thead
Sex Finale Color, calle Je
Date of Death,
Cinquet 5
190 / ; Age, ..
22 Years, / Months,
14 Days.
Maiden Name, ( Hmmfriet widowed ! dr divbreed.
Strela Chapin ban
Husband's Name,
Single, Married, Widowed or Divorced, Ledoulidt Occupation,
*Residence, { If out of town, )
Jamaica, Vermont
Place of Birth,
¿ also state fully. }
*Place of Death,
Northug, Man, Moore at.
Name and Birthplace of Father,
Claix Young
-
Maiden Name and Birthplace of Mother Luna Unna Chapin Jamaica It
Jamaica Demont
Place of Interment, (Give name of Cemetery),
Dated at
on
auquel 5"
.. 190 /
Signature and place of business of Undertaker.
Summer efloyd
Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Sulla O Read Age, 52Y. / M. 19 D.
Place and Date of Death, died at .. Winthrop auquel 5" 1901. carcinoma stomach Duration,
Primary,
Disease or Canse of Death, } Secondary,
Sapticaemia
Duration,
10 days
I certify that the above is true to the best of my knowledge and belief.
9 H. GBoard
M. D.
Signature and Residence of Certifying Physicjan.
Winthrop- Mars
Date of Certificate,
august 5
190 /.
· Give also street and number, if any. t Give sey of infant not named. If still-born, so state. { If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No. 40
RETURN OF THE DEATH
OF Sletta Chapin Read more sheet Winthrop mass at
Date, august 5'
.190 ..... / _.
Filed, august 6" 1901.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after sueli death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forthi tlie required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebelliou, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtaiu the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall fortliwith countersign and transmit the same to the clerk of the city or town for registration.
.. ..
" dollars
[7.'00-37-XX M.]
Permit No.
RETURN OF DEATH.
BOSTON.
Date of death
Year, /90%. Month, aug.
Birth
Year, 1854
Years,
Age 3 Months, .. %. Dạy
Days,. 26. John A. Dank Residence, Nanetu of Day, 10
Name in full, Maiden name,. Male. Remate.
Sex Conjugal condition
Singte. - Married. Widowed. Dirorted. Widow of.
Color
White. Black (Negro or mixed). Indian.
Japanese.
Wife of.
Place of death Street, 48 Winthrop So. Winthrop Number, Place of birth, .. Gast Boston Mass. Occupation,. Broker. +Roofer Name of Father, John 2. Maiden Name of Mother Margare Down Birthplace of Father oute SamploBirthplace of Mother, vete Lampelow Place of interment,
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Booton, .. Cinq 3.1907 .....
Name and age of deceased, Jahn a Lane
Age, 47 years.
Date and place of death, tug. 51901 HOVinthrop St Nastup Thrombus of leg !-
Disease Chief canse, ....
Contributing cause. Valvula Heart Disease .
Chief cause, ... 3. who -
Duration Contributing cause .. Two years -
I certify that the above is true, to the best of my knowledge and belief.
Namc and residence ? of physician,
.M.D.
* If in an institution, state how long an inmate and previous residence.
The office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A. M. till I P.M .. except during the months of June. July, August and September, when the office will be closed on Saturdays at 12 M .; Sundays, 10 A.M. till 12 M . Holidays, from 10 A.M. till 12 M .; other days, from 9 A.M. till 5 P.M.
Month,
John a game 48Hittrop Sheet august 5'1901
FORM O.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
8
Edward Of, NU. Waugh
Sex,
.Color,
Date of Death,.
august 6"
.190/; Age,3/ Years,
5.
Months,
17
.. Days.
Maiden Name, { If marrled, widowed }
or divorced.
Husband's Name,
Single, Married, Widowed or Divorced,
Occupation,
Unar Salesman
*Residence, { If out of town, )
also state fully.
Winthrop Mars( 15 Levis areme)
Place of Birth, Walden Mass
*Place of Death,
15 Jens avenue Ninitrop Emass
Name and Birthplace of Father, Stephen F. M. maugh.
Ireland
Maiden Name and Birthplace of Mother,
annie Coran
Ireland
Place of Interment, (Give name of Cemetery), Winthrop Reservetery
Dated Winthrop
on ang-8'
190 /
Signature and place of business of Undertaker.
Summer Floyd 18 Hermon Chael
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Edward of me hangh
Place and Date of Death, died at. 15 Nuño ave
Age,3/ Y.5 M. /7D. ang 6℃ 190/ .
Primary,
Ptomane Pramina
Duration,
10 days
Disease or Cause of Death, # Secondary,
Chronic ulcerative Colitis Duration, 2 450
I certify that the above is true to the best of my knowledge and belief.
signature and Residence S of Certifying Physician.
M. D.
Date of Certificate, any
8h 190 /.
· Give also street and number, if any. | Give sex of infant not named. If still-born, so state.
{ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No. 42
RETURN OF THE DEATH
OF
Edward Fino Waugh 115 Фниё Оление
Date, august 6 ... 190 ___.
Filed, august y 190 ____
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death oceurs, the oldest person next of kin present at the time of the death of auy of his kindred, or the person in charge of an institution in which a death oceurs, shall, within five days after the date of sneh a death, give notice thereof to the board of health or to the elerk of the eity or town in which the death ocenrred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the elerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forthi the required faets.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When sueli statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the elerk of the city or town for registration.
.. af - 1.11 ...
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL/NAMES TO BE IN FULL.)
Name, Jeanette Hope excelen ........ Sex, F Color,
Date of Death, august y"
190); Age, 86 Years, 10 Months, 22 Days.
Maiden Name, { If married, widowed ) or divorced. Jeanette Hope Prove
Husband's Name, John l, viajen
Single, Married, Widowed or Divorced,
Occupation,,
Terrace avenue, Winthrop Mace
*Residence, 3
{ If out of town, {
¿ also state fully.
Place of Birth, Billtown N. 8,
*Place of Death,
J'enrace Chenne Winthrop Mass
Name and Birthplace of Father, Jamee Roscoe Massachusetts
Maiden Name and Birthplace of Mother, Copabelle Robinson=Scotland
Place of Interment, (Give name of Cemetery), Minttuof Cemetery
Dated at
Printhuapo
Summer Ofloyd
Signature and
5
on
auquel y
190/
place of business
of Undertaker.
18 @Jerman@cel
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Jeanette Hoppe Juppeen Age, 86 5.10 M 22 D.
Purtrop Terrace Thence Aluguel y" 1901.
Place and Date of Death,
died at.
Arterio Delensio
Disease or Cause - Primary,
Duration,
3 yrs
of Death, ¿
Secondary,
Душу
Duration,
10 days
I certify that the above is true to the best of my knowledge and belief.
Grace Joule
M. D.
Signature and Residence §
of
Certifying Physician.
august 111 1901
Date of Certificate,
790 .
* Give also street and number, if any. t Give sex of infant not named. If still-born, so state.
{ If a Soldier or Sailor In the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No. 43
RETURN OF THE DEATH
OF
Jeanelle Hope uppeen Winthrop (Terrace Avenue) at
Date, Aluguel y"
1901
Filed, Cliquel 8 190 ___.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for registration.
Damplių for tinlation no not exceeding fifty dollars.
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
William Winthrop Roberts
Sex, Color,
Date of Death,
august 16
190 /; Age, Years
Months,
Days.
Maiden Name, { If married, widowed ) or divorced.
Stilllow
Infant
Husband's Name,
-
Single, Married, Widowed or Divorced, Occupation,
*Residence, { If out of town, )
Minitrope mass
¿ also state fully.
Place of Birth,
Read Street Winthrop mass
*Place of Death,
11
"1
Name and Birthplace of Father, Odugh H. Roberts 82
Maiden Name and Birthplace of Mother, Minute FOunningham (Biotin)
Place of Interment, (Give name of Cemetery),
Nontrop Cemetery
Dated at
Winthrop
Summer Floyd
on
august 17
.190/
Signature and
place of business
of Undertaker.
18 Herman Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
William Hanchop Robert ge,
Suitecom
Place and Date of Death,
died at.
Winthrop Mass- Read RI-Queg 1 6"1901
Disease or Cause
of Death, #
Secondary,
Duration, Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
Certifying Physician.
M. D.
Date of Certificate,
190 /.
* Give also street and number, if any. t Give sex of infant not named. If still- born, so state. { If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Primary,
Bullbar_
No.
RETURN OF THE DEATH
OF William Niturp Bolest Winthrop (Read Sheet) at
Date, august 16"
190.72.
Filed, august 17"
190/_
..
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death occurs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to the board of healthi or to the clerk of the city or town within the Commonwealth at which liis vessel first arrives after such death.
SECTION 8. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In case the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper authorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for .. ..
FORM C.
Commonwealth of Massachusetts.
No. 44
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name Herbert alford Jarabee
Sex. Color,
Date of Death, august 28
190%; Age, 39 Years,
Months,
Days
Maiden Name, If married, widowed
or divorced.
-
Single, Married, Widowed or Divorced,
.. Occupation,
merchant
*Residence, { If out of town, )
¿ also state fully.
15, Protect avenue (Cottage Odile)
Place of Birth, Portland maine
*Place of Death, 15 Prefect avenue (Collage dice)
Name and Birthplace of Father, Robert Janrabee (Portland mano
Maiden Name and Birthplace of Mother,
Lydia Smith, Litchfield me
Stinchap Cemetery
Place of Interment, (Give name of Cemetery),
Dated at Winthrop
Summer Floyd
august 29' 190 /
Signature and place of business of Undertaker. Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Herbert a. Samabu Age, 34 Y.N . M.
.D.
Place and Date of Death,
Primary,
Disease or Cause of Death, ţ Secondary,
Peritonitis
Duration, 24 hrs
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
I.g. Partes.
M. D.
Certifying Physician.
Date of Certificate, aug. 30. 190/.
* Give also street and number, if any. | Give sex of infant not named. If still-born, so state. { If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health. Qua 25
..
-
Husband's Name, .... - ~
died at ..
Winthrop
aug. 25 Th
190/ .
Pyle phlegutes (deeppuration). Duration,
6 days
No. 44
RETURN OF THE DEATH
OF Hubert a Layaber at 15 Prospect are"Car lile
Date, august 28" 1901.
Filed, aluguel 29- 1901.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death oecnrs, the oldest person next of kin present at the time of the death of any of his kindred, or the person in charge of an institution in which a death oecnrs, shall, within five days after the date of such a death, give notice thereof to the board of health or to the clerk of the city or town in which the death occurred.
SECTION 7. The commanding officer of a vessel shall give notice of the death of any person under his charge to tlie . board of health or to the clerk of the city or town within the Commonwealth at which his vessel first arrives after such death. SECTION 8. Penalty for neglect to comply with the requirements of seetions 6 and 7, five dollars.
SECTION 10. A physician who has attended a person during his last illness shall forthwith after the death of said person, upon request, furnish for registration a certificate setting forth the required facts.
SECTION 11. In ease the deceased was a soldier who served in the war of the rebellion, give both the primary and the secondary or immediate cause of death as nearly as he can state the same. Penalty for refusal or neglect, ten dollars.
SECTION 12. Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain „the physician's certificate made in accordance with section 10, and return it, together with the facts required by section 1, to the board of health or to the clerk of the city or town in which the death occurred.
[EXTRACTS FROM CHAPTER 437, ACTS OF 1897.]
SECTION 1. No human body shall be buried in a city or town or removed therefrom, until a permit therefor shall have been received from the proper anthorities. No such permit shall be issued until a written statement, as required by law, has been furnished, with a physician's certificate of the cause of death. When such statement and certificate are delivered to the Board of Health, the board or agent shall forthwith countersign and transmit the same to the clerk of the city or town for regiatration.
FORM C.
Commonwealth of Massachusetts.
No. 45
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
Name, Bylvan uranus. Jaune
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Sex,
.Color,
Date of Death,
august 28'
190 / ; Age,
80 Years,
/
Months, Days.
Maiden Name, or divoreed.
{ If married, widowed }
Husband's Name,
Single, Married, Widowed or Divorced,
.Occupation,
Courrier
*Residence, { If out of town. )
¿ aiso state fully,
Winthrop Mass
Place of Birth, Brewster Mass
no 3 Hitap St" Winthrop, Mass.
*Place of Death,
Name and Birthplace of Father, Barney Payne- Brewster Mass
Maiden Name and Birthplace of Mother, Sarah Ridley- Point Shirley)
Place of Interment, (Give name of Cemetery), Winthrop Cemetery
Datcd at Winthrop
Summer Floyd
on august 29' 190 /
Signature and place of business of Undertaker.
Winthrop mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Disease or Cause of Death, Secondary,
Primary,
arteriosclerosis
aug 28" 190/ .
4
Duration, / year
Heart failure
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
26. J. Soule
M. D.
of
Certifying Physician.
Winthrop
Date of Certificate, aug 27 190/ .
* Give also street and number, if any. t Give sex of infant not named. If still-born, so state.
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