USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1900-1903 > Part 8
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(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Name,
Olive Gertrude amee
Sex
Color,
Date of Death, January 30
190; Age Years,
6 Months, ~ Days.
Maiden Name, {If married, widowed ) or divorced.
Husband's Name,
Single, Married, Widowed or Divorced.
Occupation,
*Residence,
[ If out of town, {
Winthrop Sase
¿ also state fully. 3 ....
Place of Birth,
brest avenue Winthrop Beach
*Place of Death, 11 11 "
Name and Birthplace of Father, Edward 6, Amee Bo. Jammouth Or. O.
Maiden Name and Birthplace of Mother, Louise It, Betts Boston Mass
Place of Interment, (Give name of Cemetery), Sintrop Cemetery
Dated at
Winthrop
Signature and
Summer floyd
on January 31' .190 /
place of business
of Undertaker.
Winthrop grass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Place and Date of Death,
Primary,
1
Ритиона
Fany 30 190 /. Duration, 6 days
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. 29-30
died at
Disease or Cause of Death, } Secondary,
Olive Gertrude Tunus
Age,~Y.
6
M.D.
1
No .. 6
RETURN OF THE DEATH
OF Olive Sertudo Omes
Greek avenue at
Date=
January 30
Filed,. January 20 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 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 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 negleet, 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.
Penalty for violation not exceeding fifty dollars.
11
FORM C.
Commonwealth of Classachusetts.
No.
RETURN OF A DEATH.
To the Clerk of the City or Town in which the death occurred.
Name, ..
Haller It, Weller
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
Sex,
m
Color,
Date of Death,
February 10" 190 1; Age, 41
.Years,
~Months,
~Days.
Maiden Name, { If married, widowed) or divorced.
Husband's Name,
-
Roxather
Single, Married, Widowed or Divorced,
Oceupation,
Freman.
Businesses
*Residence, also state fully. )
Winthrop Mass
{ If out of town, {
Place of Birth, Conway A. Oct.
*Place of Death,
10, benthe Sweet-Dimitrios
Name and Birthplace of Father, William Webster
Maiden Name and Birthplace of Mother, Sarah Fessenden Brownfield me
Place of Interment, (Give name of Cemetery);
Winthrop Cemetery
Dated at Waltrop
Bummer floyd
on
February !!
190 /
Signature and
place of business
of Undertaker.
Minttrop Strass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Age,
.. M .. ... D.
Place and Date of Death,
dicd at. 10 Centros1 Winthrop /26101901.
Disease or Cause of Death, } Secondary,
Primary,
Phthisis Polinondis
Duration, () wo years,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence § of Certifying Physician. grand UN Hi fittan, M. D.
Date of Certificate, 726.10
190 /.
· 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 Secondary Cause.
IS Princeton St, 9, Berlin
Countersign and transmit to the clerk of the city or town.
Agent pf Board of Health.
No. 7
RETURN OF THE DEATH
OF Waller H. Webster at 10 Centre Sheet
Date, February 11 190 1.
Filed,
[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 faets.
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 certifieate 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 elerk 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.
SECTION 5. Penalty for violation not exceeding fifty dollars.
FORM O.
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, .
Enfant (Vasker)
Sex, nu Color,
Date of Death, !
February 21
Stillborn
190/ ; Age, ~Years, Months, ~Days.
Maiden Name, { If married, widowed ) or divorced.
Husband's Name,
Single, Married, Widowed or Divorced, Occupation,
*Residence, { If out of town, ) ¿ also state fully.
4- Cottage Park Road initial.
Place of Birth, 4 Cottage Park Road
*Place of Death,
4 Ortage Park Road
11
Name and Birthplace of Father, Coldrence 6, Faster Charleston
Maiden Name and Birthplace of Mother, Florencem Rich Charleston
Place of Interment, (Give name of Cemetery), Winthrop Cemetery
Dated at
Minttrop
Summer Floyd
on 4
February 23
190 /
Signature and
place of business
of Undertaker.
18 Herman 122
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Enfant (asker
Age,,
Y.
0) Willlow
Place and Date of Death,
Primary,
Disease or Cause of Death, ¿ Secondary,
died at ..
H Cottage Park Road feb 2/ 1901.
Still how
Duration,
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
of
S
Certifying Physician. 23 .190/.
Date of Certificate,
* 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.
...
O& Johnson,
M. D.
Countersign and transmit to the clerk of the city or town.
Agent of Board of Health.
No.
RETURN OF THE DEATH
OF
Infant (Jasker) at 4 Oct Park Road
Date, February 21 1901
Filed, Jehuary 22 .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.
SECTION 5. 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.
Name, ..
Sarah Ran
Pantin
(FILL OUT WITH INK. ALL NAMES TO BE IN FULL.)
.. Sex,
Color,
Date of Death,
February 26"
190/ ; Age, ..
8$
Years,
8
Months,
26
Days.
Maiden Name, If married, widowed }
or divorced.
Sarah Anov
Husband's Name,
Marinece Rankin
Single, Married, Widowed or Divorced, Occupation,
*Residence, {If out of town, )
¿ also state fully.
Helleeley Mars
Place of Birth,
Ireland
V
*Place of Death,
15. Pervains As Minhas mass
Name and Birthplace of Father, James Amox
Sarah Richardson-England
Maiden Name and Birthplace of Mother,
Place of Interment, (Give name of Cemetery), Hoodlam Ameter ( Wellesley) mars
Dated at Minatural.
Summer Flolid
on February 27 190 /
Signature and
place of business
of Undertaker.
Nonchrap mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Age, S/ Y & M. UD.
Place and Date of Death, died at ... Finttrop Beads
190
Healimentares of lecture Duration Untenour long Trace
Weekaustere Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence
Jane Mistagelten
M. D.
of Certifying Physician.
Date of Certificate,
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.
Feb 26
Agent of Board of Health.
1
of Death, } Secondary,
1 Disease or Cause - Primary,
No. 8
RETURN OF THE DEATH
OF
Sarah Rankin 15 Perking Street at
Date, Debuary 26 1901.
Filed, february 2% C
.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 elerk 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 forth 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 canse of death as nearly as lic 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 nntil 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 arc 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.
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, .
Maxell Kankin
Sex,
Color,
Date of Death, March 3" 1981; Age, 87
Years, Ő
Months,
3
.Days.
Maiden Name,
{ If married, widowed }
or divoreed.
Husband's Name,
Olidowed
Single, Hurried, Widowed or Divorced,
Occupation,
Farmer
*Residence, {If out of town, ) Stellesley Mack
also state fully.S
Place of Birth, Ireland
*Place of Death, 15 Perkins & livet. Winthrop Mass Name of Father, Scotland
Birthplace of Father,
Maiden name of Mother,
Birthplace of Mother,
Scotland
Place of Interment, (Give name of Cemetery),
Wordlawn Cemetery Wellesley Mas
Dated at ..
Winthrop
Signature and
Summer Floyd
on march 4 1901
place of business
of Undertaker.
Hintof mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deccascd, t
Maxwell Rankin
- Age, Sy Y. M. M. 3 D.
Place and Date of Death,}
Disease or Cause of Death, §
dicd at Hanetrap, Mar. 3g 1901. .... 189 Capillary Bronchitis und denelity
Duration of siekness,
One cercet.
I certify that the above is true to the best of my knowledge and belief.
HJ Partir
M. D.
Signature and Residence
of
Certifying Physician.
Anthrop
Date of Certificate, Man. Hx. 1901 189
Give also street and number, if any.
t Or sex of infant not named. If still-born, 80 state. { If ehild died immediately after birth, so state.
§ If a Soldier or Sailor in the War of the Rebellion, give both Primary and Secondary Cause.
mar 3
No. 9
RETURN OF THE DEATH
OF Maxwell Panini 15 Perknie Street at
Date, March 3 189
Filed, March 4 189 1.
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 eity 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 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 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.
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.)
Name,
abbie, Su, Gendry
.Sex,
F
+
Color,
Date of Death,
March 12
.1201; Age,
41 Years,
Months,
8 Days.
Maiden Name, { If married, widowed )
or divorced.
abbie Su , Men
Husband's Name,
Robert Of Ovendry
Single, Married, Widowed or Divorced,. Occupation,
Winthrop Nass
*Residence, { lf out of town, )
? also state fully
Gast Boston
Place of Birth,
*Place of Death,
15% Winthrop Street-
Name and Birthplace of Father,
William J. keen - Boston
Maiden Name and Birthplace of Mother, .. Mary E, Tower- Cambridgefert
Place of Interment, (Give name of Cemetery), ... Winthrop Cemetery
Dated at Winthrop
Summer efloyd
on
March 12"
190/
Signature and place of business of Undertaker.
Winthrop Mass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t abbe In Keen
Place and Date of Death,
Disease or Cause | Primary, of Death, # Secondary,
died at 157 Wwwhop St Pneumonia Pleuritis
Age, 41 Y. ~ M. 8 D.
Auch 122 1901
Duration,
5 days
Duration,
12 horas
I certify that the above is true to the best of my knowledge and belief.
Ben SichbMetcalf M. D.
Signature and Residence S of
Certifying Physician.
52 Um top It
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.
Mar/20
Agent of Board of Health.
No. 10
RETURN OF THE DEATH
OF abbie M Ovendry 15% Winthrop Sweet at
Date,
March 12" 1901
Filed, Search 13 190. 1
[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 forthi 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 deathi 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.
[7.'00.37-XX M.]
Permit No.
RETURN OF DEATH. BOSTON.
Date of death Year 1901 Month, Which
Birth
Year, 1869
Years, 3 1 Month, Age { Months, 3 Day, t Day 9 James H Cassaus
Days 2.5
Sex
Male. Female- Conjugal condition
Single. Married. Widowed.
Color
White. Nack (Negro or mi.ved). Indan. Chinese. Japanese.
Wife of.
Place of death § Street,
Number,
Place of birth,
Occupation, Euquicer
Name of Father,
Maiden Name of Mother, Johann Summer.
Birthplace of Father, Birthplace of Mother,. Ireland
Place of interment, Italy Goes malde
That. I. Jane
Undertaker.
PHYSICIAN'S CERTIFICATE OF THE CAUSE OF DEATH.
Writerop Mehl6ª
Boston, ..
190/ ....... .
Name and age of deceased, James Mc. bassins Age, 3 / years.
Date and place of death, *.
Disease Chief cause, Contributing cause,
Chief cause,
Duration Contributing cause,.
I certify that the above is true, to the best of my knowledge and belief. Name and residence \ Winthrop Man M.D.
of physician,
* 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 | 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.
max 15
Name in full, Maiden name,
Residence, Boudin et
1 Divorced. Widow of.
RETURN Of. 1 EATH James Or, backens Bowdown Street Died Mar 15" 1901 FILED=March 15.1901
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,
ashley Horton Jayne
Sex,.
no
Color,
Date of Death,
March 17
190 / ; Age, ~ Years,
.Months,
2 Days.
Maiden Name, { If married, widowed ) or divorced.
-
Husband's Name, - -
Single, Married, Widowed or Divorced, Occupation,
*Residence, { If out of town, )
¿ also state fully.
Otinthope Mass
Place of Birth,
35 S ashington avenue
*Place of Death,
35 Crashington avenue
Name and Birthplace of Father,
George F. Payne-Chelsea Mass
Maiden Name and Birthplace of Mother, Rate S. Peirce-Detroit-mich
Place of Interment, (Give name of Cemetery),
Mintrojo Cemetery
Dated at Northrope
Signature and
Summer Floyd
on
March 18'"
190 /
place of business 3 of Undertaker.
Winthrop Wass
PHYSICIAN'S CERTIFICATE.
Name and Age of Deceased, t
Age,
Y.
.. M. . ...... D.
Place and Date of Death, died at. Central Iremoslage
190
Disease or Cause of Death, Secondary,
Primary,
Duration,
2 days
Duration,
I certify that the above is true to the best of my knowledge and belief.
Signature and Residence S of Certifying Physician.
631 metcalf
M. D.
31 Metcalf
Date of Certificate, 19 190 | .
* 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.
No
RETURN OF THE DEATH
OF
ashley Hartan Payne
35 Washington avenue
at
Date, March 17 " 1901.
1
C Filed, March 18" 1901.
[EXTRACTS FROM CHAPTER 444, ACTS OF 1897.]
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