USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 20
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SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth-
teamamit it to the block of the city of town for registration. Penalty for violation not exceeding fifty dollars.
[5.'02-37-XXM.|
Permit No.
RETURN OF DEATH. BOSTON.
Date of death
Year 1902 Month, May
Birth
Bec Age Months,
Day,. 28
Day,
16
Days, ...
Name in full, Fired. W. Propres Maiden name,.
Male.
Sex Conjugal condition
Single. Married. Widowed. Divorced. Widow of
Residence, Lewis block Quiley at White. Color Black (Negro or mixed). Indian. Chinese. Japanese.
Wife of.
Place of death Street, 1.
Number,
Place of birth,
Occupation, ...
Name of Father, albert Maiden Name of Mother Helew Stoddard
Birthplace of Father, Procktan was Birthplace of Mother, Brockton
Place of interment,
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston,. May 28 th 1902.
Name and age of deceased, Fred. A. Bumper Age, years.
Date and place of death,* May 28th, Levis BCK; Winthrop.
Disease -Chief cause, Pleuro pneumonia.
Contributing cause, .. Cirrhosis (Biliar) of the Liver
Chief cause .... Eight days
Duration Contributing cause, Indefinite
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ? of physician, Ho J. Parter, 250 Sherise Ah, Hinteraf 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, Auguat 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.
21
Year, 18.
Years, 36
FrankW. Buwifeus May 28 . 1902
FORM C.
Commonwealth of Massachusetts.
may 2 mois
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.)
Date of Death, may 28"
190 2
Full . Name of Deceased, William Ofensy Weld
Maiden Name,
If a married or divorced woman or a widow give also Name of Husband,
Sex, Color,
Single, Married, Widowed/ or Divorced, Daigle In
Age, // Years, Months, Days. Occupation, Costumes
* Residence [ If out of town, } Mermaid avenue (Ocean Pferay)
[ also state fully. §
Place of Death, Jestin Mass 11
Place of Birth,
Frederick Held (Biston
Name and Birthplace of Father, Sarah Odiscoe Hopkinton mars
Maiden Name and Birthplace of Mother, OF mest Offices Cemetery
Place of Burial (Give name of Cemetery) ....
Summer Floyd
on may 29' 190 2 place of business of Undertaker.
/
18 Oterman Street
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Stilliam Of, Held.
Age, Cfr. ~~ D.
Place and Date of Death,
died at
Mermaid avenue May 28
190 2.
Cerebral apoplety
Duration,
6 years
Disease or of Dea
Primary,
Immediate,
Paralízis d
Duration,
6 years
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence of
Certifying Physician. Away, 30 1902
Date of Certificate,
* 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
.M. D.
Dated at
Signature and
No.
RETURN OF THE DEATH
OF William Henry Weld
Mermaid avenue at .....
Date,- Way 28"
1902 ...
Filed, .... may 29" 1902.
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose honse a death occurs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, cause notice thereof to be given to the board of health or to the town clerk.
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 shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other anthorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor 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. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tificate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making such return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS. ]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth-
Danalla for viala inn 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.)
Date of Death,. May
31 1902.
Full Name of Deceased, alva Harding
Maiden Name, ...
alva Perry
If a married or divorced woman or a widow give also Name of Husband, Odianatha Harding
Sex, Color, 21 Single, Married, Widowed or Divorced,
Age, 43 Years, 6 Months, 7 Days. Occupation,
* Residence ( If out of town, } ¿ also state fully. ) .
no 8 James avenue
Place of Death, 8. Janer done
Place of Birth, Carlton nova Scotia
Name and Birthplace of Father,
John Perry
Yamouth ND
Maiden Name and Birthplace of Mother,. Elindlett
Place of Burial (Give name of Cemetery), ....
Dated at Winthrop
Summer Oflorid
on June 1"
190 2
Signature and place of business of Undertaker. 18 Oferman Slied
.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
alva Carding,
Age,
438. 6M.7 D.
Place and Date of Death,
died at
190
Primary,
Disease or Cause of Death, # Immediate,
Natural causes
Duration,
I certify that the above is true to the best of my knowledge and belief. as I love ,
veweil the body as medical examne M. D.
Signature and Residence of Certifying Physician.
Winthrop
Date of Certificate, LA La
1902.
· 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Heart disease (Supposedly) Duration,
No.
RETURN OF THE DEATH
OF
Nus alva Standing 8 Janes Cience at
Date, May 21 190 2
Filed, 190.2.
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose honse a death ocenrs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, cause notice thereof to be given to the board of health or to the town clerk.
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 shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor 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. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tificate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making such return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS.]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law. with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth- +1 +ranamit it, to the clerk of the city or town for registration. Penalty for violation not. execoding fifty dollars.
FORM C.
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.)
Date of Death, May 31
1902
Full Name of Deceased, Elizabeth C, Davis.
Maiden Name, 11 brane
= = married or divorcea ) woman or a widow give also (
Name of Husband, Samuel Il, Dar's
Sex, Color, Single, Married, Widowoder Divorced,
Age, 82 Years, Months, Days. Occupation,
* Residence { If out of town, } lanton Mass
¿ also state fully. §
Place of Death, 10 north avenue Northrop Mass
Place of Birth, Cantar Mass
Name and Birthplace of Father, Eleneger Grane Canton Mass
Maiden Name and Birthplace of Mother, Betsey Paul Dedham mass
Place of Burial (Give name of Cemetery) Mount Panel Of ise Cemely fully mais
Summer Floyd1
Dated at June " 1902 on
Signature and place of business of Undertaker. 18 EHerman Sheet
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Elizabeth C, Dan's
Age, 82 r. O.M.D.
Place and Date of Death,
Primary,
died at Winthrop no. Denne May 31" 190 2 Duration,
Disease or Cause of Death, } Immediate,
Блинына
Duration,
4 diego
I certify that the above is true to the best of my knowledge and belief.
signature and ResidenceS of
Certifying Physician.
Date of Certificate, Диги 2 190 2 .-
* Give also street and number, if any. f 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
.M. D.
No.
RETURN OF THE DEATH
OF Elizabeth @ Dan's 18 North avenue at ....
Date,-
may 31
190 2 ..... .
Filed, .... ..
June 1
190 2
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every honscholder in whose house a death oceurs and the oldest next of kin of a deceased person in the eity or town in which the death oceurs, shall, within five days thereafter, eause notice thereof to be given to the board of health or to the town elerk.
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 shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required faets.
SECTION 11. If the deceased was a soldier or sailor who served in the war of the rebellion, give both the primary and the secondary or immediate eause of death as nearly as he ean state the same. Penalty for refusal or negleet, ten dollars.
SECTION 12. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tifieate required by section 10, enter thereon the facts required by seetion 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making snch return shall receive from the city or town a fee of twenty-five eents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS. ]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth- the alook of the city or town for registration. Penalty for violation not exceeding fifty dollars.
FORM C.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
(FILL OUT WITH ALL NAMES TO BE IN FULL.)
2
Date of Death, ... · Jui Denje · 190 Henry Juncker Full Name of Deceased, Maiden Name,.
woman or a widow give also -
If a married or divorced Name of Husband,
Sex, Color,
Single, Married, W idowed or Divorced,
Age,d V Years, 9 Months, / 7 Days. Occupation, Expressman
* Residence If out of town, } faiso state fully. § Sturkey -SE
Place of Death, Ickert My. Place of Birth,.
Name and Birthplace of Father, ... for, -
Henry Tucker Ankomme Maiden Name and Birthplace of Mother, Mary a. Daniel
Place of Burial (Give name of Cemetery), Cold Spring N. y.
Dated at
on
June 21 190 2
Signature and place of business of Undertaker.
18 Overmar Sheet
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t George Henry Suchen Age, 52 8. 9 M. 17 D.
Place "and Date of Death,
died at anthrop (Shirley Sheet) Jeme 2 190 2. Duration,
Disease or Cause of Death, }
Primary,
Immediate,
Apoplex
Duration,
Short
I certify that the above is true to the best of my knowledge and belief.
A. B. Downon M. D.
Signature and Residence S
of
Nuittrop Man
Certifying Physician.
Date of Certificate,
June 2%
1902
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 Immediate Cause.
Countersign and transmit to the clerk of the city or toun.
Agent of Board of He Health.
.
Commonwealth of Massachusetts.
Dime. 1
Summerloud
No.
RETURN OF THE DEATH
OF
Lenge Henry ucker Winthrop (Chile (1) at
Date,
Jeme # 1 190.2
Filed,
190 2. ... .
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death occurs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, canse notice thereof to be given to the board of health or to the town clerk.
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 shall forthwith after the death of a person whom he has attended during his last illness, at the request of an undertaker or other authorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor 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. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tificate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making such return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS.]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth- with countersign and transmit it to the clerk of the city or town for registration. Penalty for violation not exceeding fifty dollars.
FORM C.
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.)
Date of Death, ..
11Th 1902
Full Name of Deceased, E divin &
Verrill
Maiden Name,
If a married or divorced woman or a widow give also (
Name of Husband,
Sex, mala Colo Color, MehilE
Single, Married, Widowed or Divorced, Single.
Age, 77 Years, Months, ( Days. Occupation, Dol dias
Hows ude Van Sape Elizabeth, Inc. H. Banko man.
* Residence { If out of town, { (also state fully. Past Hospital, Fort Banks, mass. Place of Death,
Place of Birth, Portland, Inc.
Name and Birthplace of Father, not Kurion
Maiden Name and Birthplace of Mother,
Place of Burial (Give name of Cemetery)
Dated Forh Bank, Cristinaro Mario
Signature and
place of business
3
Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Etrain à VEAriel Age,24/ Y. M .......... .D.
Place and Date of Death,
died at.
Post Bankto mars.
Same 4 190 %.
-
Primary, Immediate,
acote Lobur Pneumonia
Duration,
I certify that the above is true to the best of my knowledge and belief.
1,31 Mel calt
M. D.
Signature and Residence of
Certifying Physician.
Winthrop mars
Date of Certificate,
190X
* Give also street and number, if any. f 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
1
on Jour. 4"
190 7
of Undertaker.
Summer Floyd
Pleuritis
Duration,
5- day
Disease or Cause of Death, #
...
No.
RETURN OF THE DEATH
oduni R. Vernice at Carl Barks ......
June 4 190. 2
Date,-
Filed, June 4
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death occurs and the oldest next of kin of a deceased person in the city or town in which the death occurs, shall, within five days thereafter, cause notice thereof to be given to the board of health or to the town clerk.
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 S. Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars.
SECTION 10. A physician shall forthwith after the death of a person whom he has attended during his last ilhess, at the request of an undertaker or other anthorized person or of any member of the family of the deceased, furnish for registration a certificate setting forth the required facts.
SECTION 11. If the deceased was a soldier or sailor 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. Every undertaker or other person who has charge of a funeral, shall forthwith obtain the physician's cer- tificate required by section 10, enter thereon the facts required by section 1, and return it to the board of health or to the clerk of the city or town in which the death occurred. The person making such return shall receive from the city or town a fee of twenty-five cents.
[EXTRACTS FROM CHAPTER 78, REVISED LAWS. ]
SECTION 38. No undertaker or other person shall bury a human body in a city, or town or remove therefrom a human body which has not been buried, until a permit from the board of health or its agent has been received. No such permit shall be issued until there shall have been delivered to such board a written statement, containing the facts required by law, with a physician's certificate of the cause of death. The Board of Health or agent, upon receipt of such statement and certificate, shall forth- tergiseu and transmit it to the clerk of the city of town for registration. Penalty for violation not a xeedding 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,
DElos
Sex,
Color,
Date of Death, FILLE 18
Maiden Name, or divorced.
190Z; Age, ~ Years, -
Husband's Name,
Single, Married, Widowed or Divorced, Occupation,
*Residence, ¿ also state fully. ) § If out of town, {
X / Deeau Vieur St.
Place of Birth, Itis, therok Dass.
*Place of Death, 1, 11
Name and Birthplace of Father, Droid & Slovy Trachadayto,
Maiden Name and Birthplace of Mother, batterier Pitts 11
Place of Interment, (Give name of Cemetery), Old Lexusbridge torre.
Frank, S. Mal sury.
Dated at
finner 18 cm
190 2,
on
Signature and place of business of Undertaker.
146 If inthok &K
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Elory
,Age, ~Y. -. M. ~. D.
Place and Date of Death,
died at.
E12€ 184 19021
Disease or Cause of Death, # Secondary,
- Primary,
Duration,
Still born
Duration,
I certify that the above is true to the best of my knowledge and belief.
A.B. Domman
M. D.
Signature and Residence S of
Certifying Physician.
Withich Mass.
Date of Certificate,
June 18th
190 2
· 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.
Months, ~. Days.
No.
RETURN OF THE DEATH
OF
Dolory
Stivelow Infant 10сеан Грейдиев at
Date,
Jeme 18"
190. 2
Filed, June 19
190 2
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
SECTION 6. Every householder in whose house a death occurs, the oldest persou uext 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 registratiou 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 ueglect, 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.
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