USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 5
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SECTION 2. No undertaker or other person shall bury in a city or town a human body or the ashes thereof brought into this Commonwealth from without its limits until he shall have received a permit so to do from the board of health, other than the select- men, or its agent duly appointed to issue such permits, or if there is no such board, from the clerk of the city or town in which the body is to be buried or the funeral riies are io be hell : provided, however, that if there is a person only appointed to have the care of the cemetery or burial ground in which the interment is made, and there is a record kept of the names of all persons buried therein, or if there is a duly appointed superintendent of burials in such city or town who keeps a record of interments. said permit may be issued by such person having such eare or by said superintendent of burials. Said permit may be granted upon delivery to said board, agent, clerk, superintendent or person having such care, as the case may be, of a certificate giving the name of the deceased person, his age as nearly as can be ascertained, the cause of death, the name of the city or town where he last resided or from which the body was brought, or, if the death occurred at sea, the name of the vessel upon which it occurred, and any other facts required for record which could be obtained with reasonable exertion. When such certificate is delivered to the board of health, or to its agent, or to the superintendent or person having such care, the board, agent, superintendent or person having such care shall forthwith countersign and transmit the same to the clerk of the city or town; and if the deceased person was at the time of his (Iceease a resident of said city or town the clerk shall record the same in the books kept for recording deaths; but if the deceased was at the time of his death a resident of any other city or town within this Commonwealth said clerk shall forthwith forward to the clerk of such other city or town a certified copy of the certificate mentioned in this section.
SECTION 3. No person having the care of a cemetery or burial ground shall permit a human body to be buried therein or removed therefrom, or permit the ashes of a human body to be removed therefrom, nntil there has been delivered to him the permit for the burial or removal of said body or ashes, nor permit the ashes of a human body to be buried therein until there has been delivered to him a certificate that the burial permit and the certificate of the medical examiner prerequisite to the cremating of said body have been duly presented.
SECTION 4. No undertaker shall bury the ashes of a human body which has been cremated until he has received from 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 of said body have been duly presented.
SEcriox 5. Any 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 or person shall convey or cause 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 preclude 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 or before the first day of May in each year, license a suitable munber of undertakers who can read and write the English language, to take charge of the funeral rites preliminary to the interment, removal or cremation of a human body. Such licenses shall be issued under such terms and upon snch conditions as the board of health may prescribe, and may be revoked at any time by the board when such terms or conditions or any requirements of law relative thereto have been violated by the undertaker : provided, however, that an undertaker so licensed shall have the right to act thereunder in any city or town in the Commonwealth.
Acts of 1897, Chap. 444, Sect. 10.
A physician who has attended a person during his last illness shall forthwith, after the death of said person, furnish for registration at the request of a duly licensed undertaker or other authorized person, or any member of the family of such deceased person, a certificate, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he dicd, the duration of his last sickness, and the date of his decease; and a physician who has attended at the birth of a child dying immediately thereafter, or a physician or midwife who has attended at the birth of a child born dead, shall forthwith furni registration a certificate stating that to the best of his or her knowledge and belief such child either died immediately after bin was born dead.
A physician or midwife who neglects or refuses to make the certificate required by this section or who makes a false staten therein shall forfeit not exceeding fifty dollars.
FORM C.
Commonwealth of Classachusetts.
No.
38
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, Henry R. Phillips
Sex, ML
.. Color,
Date of Death,
august 24.
1900 ; Age, CL Years,
6 Months, 2 0 Days.
Maiden Name, { If married, widowed {
or divoreed.
Husband's Name, ..
Single, Married, Widowed or Divorced,
Deeurpation,
*Residence, also state fully.
{ If out of town, {
16. Fremont Street,
11
11
Place of Birth,
*Place of Death,
11
Name and Birthplace of Father, Harlan Of. Phillipes - Boston Mass
Maiden Name and Birthplace of Mother, annie B. S'ilso-bula
Place of Interment, (Give name of Cemetery), et nest Oriles Cemetery
Dated at
Iculturap
Signature and
place of business
$
on
auquel 25%
190 7
of Undertaker.
Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death, #
Disease or Cause of Death, §
died at Mithras aug 24 " 1900 Pernicions anaemia. Intestinal indigestion
2 mos.
I certify that the above is true to the best of my knowledge and belief.
Ben Jriks Metcalf .M. D.
Signature and Residence § of
Certifying Physician.
Date of Certificate,
any 25-1
Give also street and number, if auy.
f Or sex of infant not named. If still-born, so state. { If child died immediately after birth, so state.
§ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Agent of Board of Health.
-
Duration of sickness,
Jerry
-Age , Y. 6 M2OD.
1,
No.
RETURN OF THE DEATH
OF
at
Date,
190.
Filed,
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 bis 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, furuish 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 towu 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 beeu furnished, with a physician's certificate of the cause of death. Wheu 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 towu for registration.
SECTION 5. Penalty for violation not exceeding fifty dollars.
Commonwealth of Massachusetts.
No.
39
RETURN OF A DEATH.
To the Clerk of the City of Town in which the death occurred.
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Wilfred Johnson Colline
Sex ,
Color,
Date of Death,
auquel 3, 1200
; Age, (Years, 8 Months, ~.... Days.
Maiden Name,
ried widow
or divorced.
C
Husband's Name,
Single, Married, Widowed or Divorced,, Occupation, Winthrop mare Verman Sheet
Place of Birth,
*Place of Death,
Shubal J. bollen's
/
Birthplace of Father,
Maiden name of Mother,
Truro mass Ella F. Tempo Tempo Nahaut Mars
Birthplace of Mother,
Place of Interment, (Give name of Cemetery), Novellawn Cemetery
Dated at ...
Winthrop
on august 3 119 5485
Signature and
place of business
of Undertaker.
Summer Floyd Minitrop ( mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Actores Soluna Collina Age, - Y. 8 MLD.
Place and Date of Death, ;
died at
Disease or Cause of Death, §
Tuarashuns
Duration of sickness,
1 unk
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence of Certifying Physician.
Egothural M. D.
Sept = 1900
Date of Certificate,
Give also street and number, if any.
t Or sex of Infant not named. If still-born, so state. { If child died immediately after birth, so state.
§ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
*Residence, { If out of town, } ( also state fully. §
Name of Father, .
No.
RETURN OF THE DEATH
OF
at
Date,
189
.
Filed,
189 .
The provisions of chapter 444 of the Acts of 1897 require that every householder in whose house a death oecurs, 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 oceurs, 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 oceurred. (Sce section 6.)
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. (Sec section 7.) Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. (Sec section 8.)
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 faets. (Sec section 10.)
Penalty for refusal or negleet, ten dollars. (See section 11.)
Any person having charge of the funereal rites preliminary to the interment of a human body shall obtain the physician's certifieatc made in accordance with seetion 10, and return it, together with the facts required by seetion 1, to the board of health or to the elerk of the eity or town in whieli the death oceurred.
Commonwealth of Massachusetts.
No.
40
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,
Raymund Edward Griffen
Sex,
m
Color.
Date of Death,
Sept 10 ", 19%
;
Age,
-Years,
11
Months,
Dayf.
Maiden Name, { If married, widowed ) or divorced.
Husband's Name, C
Single, Married, Widowed or Divorced, Occupation,
*Residence, { If out of town, /
¿ also state fully. §
62 am Ilton St Dorchester
Place of Birth,
*Place of Death,
Hautham Hotel
Cottage Stile
Name of Father,
martin. C.,
Fickdale Mass
Birthplace of Father,
Maiden name of Mother, margaret Hannon
Birthplace of Mother,
Randolph Mass
Dated at
Winthrop
Summer Floyd,
Sepet 11" 1gays
Signature and place of business } of Undertaker.
Winthrop mais
PHYSICIAN'S CERTIFICATE.
Name and
H. V. REYNOLDS, M.D. 29 MONADNOCK ST.
Place and
Boston, Maue. 189
Disease or R Sell: 10 /900
Duration ‹
aged 10 months 23 days
I c
InfanTum. He had been il
M. D.
36 hours. Dat
Give also str + Or sex of int § If a Soldier
L
M. .... ..... D.
Ca Té
milton mark
Place of Interment, (Give name of Cemetery),.
No.
RETURN OF THE DEATH
OF
at
-
Date,
189
.
Filed,
189
The provisions of chapter 444 of the Acts of 1897 require that 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 oceurs, shall, within five days after the date of such a death, give notice thereof to the board of healthi or to the clerk of the city or town in which the death occurred. (See section 6.)
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. (See section 7.) Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. (Sec section 8.)
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. (See section 10.)
Penalty for refusal or negleet, ten dollars. (See section 11.)
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 seetion 1, to the board of healthı or to the clerk of the city or town in which the death occurred.
FORM C.
Commonwealth of Classachusetts.
No. 41
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,
Date of Death,
Depetentler 14
Sex,
Color,
.. 1906 ; Age,
8/ Years,
9
„Months,
4 Days.
Maiden Name, { If married, widowed {
or divorced.
Charlotte
Juttle
Husband's Name,
Lemuel Clapp
Single, Married, Widowed er Divorced,. .Occupation,
* Residence, ¿ also state fully,
{ If out of town, {
174 Pleasant RV timeof mass
Place of Birth, Dele mans
*Place of Death,
17my Pleasant IT Vinturp Suass
Name and Birthplace of Father. Charles Tuttle- Hvamieter mass Maiden Name and Birthplace of Mother, Sarah Quelin- Salem Mass
Place of Interment, (Give name of Cemetery),
Old North Cemetery Fordista Mass
Summer Floyd
Datedzat.
on Dept 15
190 0
Signature and place of business of Undertaker. Minttrop Mars
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t Charlotte Tutte ClaphAge, 8/Y. 137. Pleasant st.
.M . ..... ....
.D.
Place and Date of Death, # died at hoop Contre Mac. Sept. 1/1900.
Disease or Cause of Death, §
Senile Dobility.
Duration of sickness,
not known
I certify that the above is true to the best of my knowledge and belief.
May 18. Currier M. D.
Signature and Residence S of Certifying Physician. Somerville, Mass.
Date of Certificate, Sept. 16, ... 189.00.
Give also street and number, if any.
+ Or sex of Infant not named. If still-born, so state. # If ehild died immediately after birth, so state. § If a Soldier or Saflor in the War of the Rebellion, give both Primary and Secondary Cause.
No.
RETURN OF THE DEATH
OF
at 4
Date,
190.
Filed,
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 auy of his kindred, or the person in charge of au 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 thic 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 registratiou.
SECTION 5. Penalty for violation not exceeding fifty dollars.
Commonwealth of Massachusetts.
No. 42
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,
Frank Winthrop etlyme
Sex, In. Color,
Date of Death, September 15" 1900; Age, 4 Years, 7 C Months, Days.
Maiden Name, { If married, widowed } or divoreed.
C
Husband's Name,
Single, Married, Widowed or Divorced,
Oeeupation,
no. 3 Sea Viero-avenue
*Residence, { If out of town; )
¿ also state fully. §
Place of Birth,
nii3, Sea View avenue Dinction.
*Place of Death,
no 3 Sea View avenue
Name of Father,
D. Frank Flym.
Princeton mass
Maiden name of Mother,
Sarah Pike
Birthplace of Mother, ....
Place of Interment, (Give name of Cemetery),
Italy Ones Cemetery Malden
Dated at Winthrop
Summer Floyd
September 15" 1900
Signature and place of business of Undertaker.
3
Winthrop mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Franck W. Flynn
Age, 4Y. 7 M.D.
Place and Date of Death, #
Disease or Cause of Death, §
died at Winthrop September 1 56 789-1900 Entero Colitis
(Contentis )
Duration of sickness,
Jun days
I certify that the above is true to the best of my knowledge and belief.
signature and Residence S 26 2 dana
of Certifying Physician.
Date of Certificate,
Def 16th
1900
Winthrop Mais
M. D.
Give also street and number, if any.
t Or sex of infant not named. If still-born, so state. ¿ If child died immediately after birth, so state.
§ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
Birthplace of Father,
No.
RETURN OF THE DEATH
OF
at
Date,
189
.
Filed,
189 ...
The provisions of chapter 444 of the Acts of 1897 require that 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. (See section 6.)
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 his vessel first arrives after such death. (See section 7.) Penalty for neglect to comply with the requirements of seetions 6 and 7, five dollars. (See section 8.)
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. (See section 10.)
Penalty for refusal or neglect, ten dollars. (See section 11.)
Any person having charge of the funereal rites preliminary to the iuterment 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.
Commonwealth of Massachusetts.
No.
43
RETURN OF A DEATH.
To the Clerk of the City of Town in which the death occurred.
Name, George F. Yan X(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.) Tauson
Sex, Color,
Date of Death,
Belet 17"19 185 ; Age,
Maiden Name, { If married, or divorced.
Years, Months, 14 Days.
Husband's Name, ...
Single, Married, Widowed or Divorced -Deettpation,
* Residence, { If out of town, )
Hinthraje Mass
, ? also state fully. §
Place of Birth,
H2 Bowdown Steel
*Place of Death,
42 Bondi Sheet
Name of Father,
George F. Lawson
Birthplace of Father,
St John F. B.
Maiden name of Mother,
Nellie R. Delaney
Birthplace of Mother,
East Balón.
Place of Interment, (Give name of Cemetery), Wordlama Denley.
Dated at.
Winthrop
on Sept 1 7"
Signature and place of business of Undertaker.
Brunner Floyd
Winthrop (mass
PHYSICIAN'S. CERTIFICATE.
Name and Age of Deceased, t
Bro. 7 Lawson
Place and Date of Death,#
died at 42 Bowdown St Sept17
Age, .......
.Y.
M. 14 D.
188 00
Disease or Cause of Death, §
Mal nutrition
Duration of sickness,
10 days
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of
M. D.
Certifying Physician.
h
Date of Certificate, ceptis" 18900
Give also street and number, if any.
+ Or sex of Infant not named. If still-born, so state. # If child died immediately after birth, so state. If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
No. RETURN OF THE DEATH
OF
at
Date,
189
....
Filed,
189
.
The provisions of chapter 444 of the Acts of 1897 require that 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. (See section 6.)
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. (See section 7.) Penalty for neglect to comply with the requirements of sections 6 and 7, five dollars. (See section 8.)
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 facts. (See section 10.)
Penalty for refusal or negleet, ten dollars. (See section 11.)
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.
[7.'00.37-XX M.]
Permit No.
no 44
RETURN OF DEATH. BOSTON.
Winthrop Mass
Date of death Year, 1900 MonthSept- 200 Day
Year,
1900
Years,.
Month,.
Jeff Age Months,.
Day,
Days, ..
Name in full,
Maiden name,
Male.
Sex-
Conjugal condition
Single. Married. Widowed.
Color
White. Black ( Negro or mixed ). Indian. Chinese. Japanese.
Wife of
Place of death
Street,
$30 Shirley
Number,
Place of birth,
Occupation, Barbatder
Name of Father, Thomas P.
Maiden Name of Mother Mary J. Morrishace
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