USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 23
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Part 1 | Part 2 | Part 3 | Part 4 | Part 5 | Part 6 | Part 7 | Part 8 | Part 9 | Part 10 | Part 11 | Part 12 | Part 13 | Part 14 | Part 15 | Part 16 | Part 17 | Part 18 | Part 19 | Part 20 | Part 21 | Part 22 | Part 23 | Part 24 | Part 25 | Part 26 | Part 27 | Part 28 | Part 29 | Part 30 | Part 31 | Part 32 | Part 33 | Part 34 | Part 35 | Part 36
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death oeenrs and the oldest next of kin of a deceased person in the city or town in which the death oeenrs, shall, within five days thereafter, cause notice thereof to be given to the board of health or to the town elerk.
SECTION ". 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 sneh death.
SECTION 8. Penalty for negleet 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 deecased 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 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 seetion 10, enter thereon the facts required by section 1, and return it to the board of health or to the elerk of the city or town in which the death ocenrred. The person making such return shall receive from the eity 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.
[2-01-37-XXXM.]
Permit No.
RETURN OF DEATH.
BOSTON.
Date of death Year, 1902. Month Cluq.
Birth
Month,
Months,. 3
1g. Kul Erge Mm. Bartley
Day, . ..
16.
Days, n
Maiden name, Male. Sex Female.
Conjugal condition
Single. Married. Widowed. Divopaod. /widow of. Dou Coure HOircuit Roads.
Wife of
Place of death Street, Number,
Place of birth,
Occupation, stered Maiden Name of Mother, Many
Name of Father,
Birthplace of Father,
Birthplace of Mother,
Sont.
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, Qua.
1902
Name and age of decelised, Forg & Nm. Ganley Age, 82 years. Date and place of death, Aug. 18'1902. Co quil grine Roads.
Disease Chief cause,
Contributing cause, Cholera eporto.
Chief cause, ...... ..
Duration Contributing cause, ..
I certify that the above is true, to the best of my knowledge and belief.
Name and residence ? of physician,
Mr.BM Michal. M D.
* If in an institution, state how long an inmate and previous residence.
Tha office of the Board of Health will be open for the granting of permits for burial, as follows : - Saturdays, 9 A.M. till | P.M., excapt 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.
Year, 1820.
Years, 82.
Residence, H mithras White. Color Black (Negro or mixed). Indian. - Chinese. 1 Japanese.
Place of interment,.
George Iron Isentley august , 8"1902 Onulf Park (Circuit Road) Filed aug 20"1902
ung 19
[FORM NO. 37.]
No. of Permit,
UNDERTAKER'S RETURN. Boston.
Date of death, Dug 198 1902
Name,. Chas. Fr. Harfield
Maiden name,*
Sex, Male
Married, single, or widow of wife of
M. Age,37 years, 27 mos., 12 days. Residence, WolfloHollan@Gmail.Com
Color,
Place of death (street and )
number ) Werfleet- Collar Coral and whenthe Man
Place of birth, Dalton - Ohio.Occupation, Salesman
Name of father, Maiden name of mother, Juan- Fletcher.
Birthplace of father Intehugh Birthplace of mother, , Dallon Ohio
Place of interment,t Comprary Deposit Receiving Nomb?
* If a married woman or a widow.
t Give the name of the burialground.
(Maler) Milton Com
ErDennson
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Boston, ..
aug. 20th
1802
189
Name and age of deceased Char. I. Hatfield
Age ...
37 yrs. 2 mos.
12 aus.
Date and place of death: (lug. 19th/
Disease or cause of death:
Pistolwarns of Theads
Suicide
Duration of disease : *
I certify that the above is true, to the best of my knowledge and belief.
Name and residence
of physician.
}
M.D.
* It is very desirable to be informed of the duration of the disease. When more than one cause of death is mentioned state the duration of each.
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.
august 19-1902 Filed aug 21"1902 Gral Che- Ocean Deray
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, august 28 190
Full Name of Deceased guarelig Floyd
Maiden Name, Lucretia Senkefury
If a married or divorced woman or a widow give also ( Name of Husband, .. Edward Ofloyd
Sex, Color, Single, Married, Widowed or Divorced,
Age, 79 Years, 11 Months, 3 Days. Occupation, Hewenige
* Residence { If out of town, } ¿ also state fully. ) .. H Main Street ( Hinttugge Mass)
Place of Death, 74 Mai Sheet 1.
Place of Birth, .. Chelsea
Name and Birthplace of Father, John Dr. Denkechung (Chelsea Was)
Maiden Name and Birthplace of Mother, . abagate J. Blinger
Place of Burial (Give name of Cemetery)
Winthrop Cemetery
Dated at Winthrop
Dunner atloud
on
august 29
190 2
Signature and place of business of Undertaker.
18 Oferman Chcel
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Age, Y / M. ? D.
Place and Date of Death,
died at
1 1902.
Disease or Cause of Death,
Primary,
(Internal felerario
litie
Duration, .
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
Certifying Physician. 27 Partir h clint
M. D.
Date of Certificate, 24 190 1.
* 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.
1
Duration,
heli fuentes
Immediate,
aug 2 0
No.
RETURN OF THE DEATH
OF
Lucretia Atloud
If Main Street ........
at . ....
Date,- august 28. 190. 0 2.
Filed, august 29. 1903 .... .
[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 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 lur, 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.
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
Date of Death, august 28 18
(FILL OUT WITH INK. . ALL NAMES TO BE IN FULL.)
1902 Full Name of Deceased,
Lowell a Look
Maiden Name,
¿ Is a married or divorcea woman or a widow give also Name of Husband,
Sex, Color, SW 21 Single, Married, Widowed or Divorced,
Age, 65 Years, 6 Months, 4 Days. Occupation,
Melrose Gase * Residence (If out of town, ) {also state fully. ) .
Place of Death, Trident avenue Haithey Make
Place of Birth, addison Maine
Oliver Look addieom Manie
Name and Birthplace of Father, Fannie Norton Plymoutil Mais
Place of Burial (Give name of Cemetery), ..... Harrington Marie
Dated at
Signature and
Summer etloy d
on
august 29
190
2.
place of business
of Undertaker. 18 Overman Rtract
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Lowell a, Dark Age, 65 Y. 6 M. 4 D.
died at.
hal Inden The aug 28 90 2
Genebral Hemorrhage Duration,
Four weeks
Disease or Cause of Death, ¿ Immediate,
Primary,
Paralysis
Duration,
Two weeks
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
Edward 7 Tage
M. D.
S
of
Certifying Physiclan.
131 Greet Ane Winthrop
Date of Certificate,
Aug 29
190 2.
· 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 town.
Agent of Board of Health.
Maiden Name and Birthplace of Mother,
No.
RETURN OF THE DEATH
OF Doncle a. Look Trident avenue at
Date, august 28 1902
Filed, august 29 190 2
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every householder in whose house a death ocenrs and the oldest next of kin of a deceased person in the city or town in which the death ocenrs, shall, within five days thereafter, eanse notice thereof to be given to the board of health or to the town elerk.
SECTION ". 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 nndertaker 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 canse of death as nearly as he can 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 eer- tificate required by seetion 10, enter thereon the faets 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 snch return shall receive from the eity 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 hnman 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 snch statement and certificate, shall forth-
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, Quy 29 190 2.
Overventa amaliaa
Soluson
Full Name of Deceased, não
Maiden Name, Henneta amelia Canter
If a married or divorced woman or a widow give also § Name of Husband, Jolie Hooter Johnson
ghidowed Sex, Color, enlietiSingle, Married, Widowed or Divorced, ...
Age, § 3 Years, / 0
Months, 1.9 Days. Occupation,
* Residence (If out of town, )
{ also state fully. )
114 Broadland At Hartford, Care
Place of Death, Hotel Loving, Winthrop, Quais
Place of Birth,
London, England
Name and Birthplace of Father, James Carter, London, England
Maiden Name and Birthplace of Mother, Ried. Kent, England
Place of Burial (Give name of Cemetery) ... Oakwood Circling, Chicago, Se
Dated at
Winthrop mars
Signature and
place of business
on
august 30th 190 2.
of Undertaker.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased dennetta Amelia Johnew Age, 83 x 10 N. 19 D.
Place and Date of Death,
died at
Trung Hotel Court Road aug 29 190 2
Disease or Cause of Death, #
Primary, Immediate, Aproplepy
Duration,
Duration,
36 hours
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S
of
Albat 3. Domman
M. D.
Certifying Physician. Wivitheo Man
Date of Certificate,
duy.
30th-
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 town.
Agent of Board of Health.
ara 24
No.
RETURN OF THE DEATH
OF Ofenzietta amelia Johnson at Hotel Loving Court Road august 29 Date, 1902.
Filed, ....
august 30 190 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, eanse 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 faets required by section 1, and return it to the board of health or to the clerk of the eity or town in which the death occurred. The person making snch 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-
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, JEfel- 4th
Full Name of Deceased, John. fr. Leurs 190 2
Maiden Name, ..
If a married or divorced woman or a widow give also Name of Husband,
Sex, Color, Single, Married, Widowed or Divorced,
Age, 2 ℃ Years,
Months, 28 Days. Occupation,
* Residence { If out of town, } " Hutchinson &. Muthuof Mass. { also state fully. j .. .. Place of Death,
Place of Birth,.
Tohum
Name and Birthplace of Father, Frank. S. Preis
Bouton-Mass
Maiden Name and Birthplace of Mother,. annia Grafi Dpfrosell Maro Place of Burial (Give name of Cemetery), .... Ermetary
Dated at Findlay Left. 5h 1902 on
Signature and place of business of Undertaker.
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
died at 17 Hulchrom 85
190 2
-
Primary,
Phthisis Pulmonaria
Duration,
2 yrs
Duration,
I certify that the above is true to the best of my knowledge and belief.
Biomet call
Signature and Residenee S of
M. D.
Certifying Physician.
Wormstrop mar
Date of Certificate, Sept 5 190 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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
Age, 26 8 M28 D.
Disease or Cause of Death, } Immediate,
Super 4
No.
RETURN OF THE DEATH
John OF Years, OF at
....
Date, Syet H. 190 2
-
Filed, Dept 51 190. 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, 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 snch 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 shull 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-
r fifty Jallara
FORM C.
Commonwealth of Massachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
Date of Death, September 9 -7 (FILL OUT WITH INK. ALL NAMES TO BE IN FULL.) 190 2
Full Name of Deceased,. Norman Davis Belcher
Maiden Name,
If a married or divorced woman or a widow give also Name of Husband,
Sex, Color, Single, Married, Widowed or Divorced, ....
Age,( 10 Months,
Days.
Occupation,
* Residence [ If out of town, } also state fully.
Winthrop Mass
Place of Death, Pauline Street
Place of Birth, 10 Pauline Steel
Name and Birthplace of Father, Charles D. Belcher
Maiden Name and Birthplace of Mother, Katherine Bonden Nova Scotia
Place of Burial (Give name of Cemetery)
Winthrop Cemetery
Dated at.
on
Sujet 10
190 2
Signature and place of business of Undertaker. Dr Herman Che
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Primary,
Disease or Cause of Death, # Immediate,
Norman Davies Belcher Age, ~x. 10 M. T
D.
died at
Winthrop ya Pauline Il Seper 9
190
Cholera Infanten
Duration,
7 days
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
M. J. Soule
M. D.
of
Winthrop Mas
Certifying Physician.
Date of Certificate,
Sep 10
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 Immediate Cause.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No.
RETURN OF THE DEATH
OF
Norman Davis Belcher
yo Pauline Clicel at ....
Date, f
190 2 ..
Filed, September 10" 1902
[EXTRACTS FROM CHAPTER 29, REVISED LAWS. ]
SECTION 6. Every honscholder in whose honse a death oeenrs 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 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 negleet 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 seeondary or immediate canse of death as nearly as he can 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 seetion 10, enter thereon the faets required by seetion 1, and return it to the board of health or to the clerk of the eity 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 bnry 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-
-
[2-01-37-XXXM.]
Permit No.
RETURN OF DEATH. BOSTON.
1902
Date of death Year,. Month,
Birth
Year, Month,
Age ‹
Years, Months, 1 Days
20 2
Day , ..
9
1 Day, .....
68 Downtington am White. Black (Negro or mixed). Indian . Chinese. Japanese.
Wife of
Place of death? Street,
Place of birth, Occupation, .. Südsub Name of Father, Swanton C.C. Maiden Name of Mother sabella Lambert Birthplace of Father, Lynn lun Birthplace of Mother, Brunswick lu Place of interment,
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