USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 23
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SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE RANK, RATING ORGANIZATION AND OUTFIT.
SERVICE NUMBER
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
HALL ATS Carl
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH How z
Registered No.
54
No. 140 Highland Ave Victor Allen 2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No. 56 Spencer Ave
St. Chelsea
(If nonresident, give city or town and State)
Length of stay: In place of death
.years ..
months 1.
days. In place of residence 35years.
.months.
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
MARCH
14 1958
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
FEB 12
19.
58
That I attended deceased from
to MARCH 14 195F
I last saw h/ Lalive on
MARCH 13, 1958, death is said to
have occurred on the date stated above, at
IA
m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
ARTERIOSCLEROTIC
HEART DISEASE
INTERVAL BETWEEN ONSET AND DEATH 3 YRS
Due To (b)
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed?
NO
What test confirmed diagnosis?
5 Was disease or injury in any way related to occupation of deceased?
If so, specify. -.
NO
(Signed)
Jack K. Holmes , M. D.
(Address) CINCINO MED. CIR CONCORDate MARI4 1958
Holy Cross 0
Lalden
(City or Town)
DATE OF BURIAL Larch
17
1958
19
7 NAME OF
FUNERAL DIRECTOWilliam F. Welsh
ADDRESS
718 Broadway Chelsea
Received and filed MAR 19 1958 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED idowed
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
Elizabeth
Gaudet
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGES
Years.
Months
.Days
If under 24 hours
Hours ...
Minutes
13 Usual
Occupation :
Laborer
(Kind of work done during most of working life)
14 Industry
or Business :
Rubber_Lill
15 Social Security No ....
012-12-7333
16 BIRTHPLACE (City)
(State or country)
Canada
17 NAME OF
FATHER
Sylvere Allen
18 BIRTHPLACE OF
Canada
FATHER (City) (State or country)
19 MAIDEN NAME
OF MOTHER
Could not be learned
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Canada
21
Informant
Alfred Allen
(son)
(Address)4 Prospect Ave Chelsea
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued : Ralph E-Serianni (Signature of Agent of Board of Health or other)
1.0. March 15, 1955
(Official Designation)
(Date of Issue of I'ermit)
X
X 1 -
-301A
TIONS
TIFICATE
ing DEATH enter n one · each and (c)
not mean of dying, t failure, It means or compli- h caused
if any, rise to re
(a), under- e last.
contrib- - h but not e terminal ion given
pter 137, requires o print or cause or
death on
cates.
To be filed for burial permit with Board of Health or its Agent.
J(If death occurred in a hospital or institution,
St. (give its NAME instead of street and number)
PHYSICIAN -- IMPORTANT
(Was deceased a
no
U. S. War Veteran,
if so specify WAR)
(Usual place of abode)
Chelsea 35x+
SOM-5-36-917573
Place of Burial or Cremation
PARENTS
ale
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
A physician or registered hospital medical officer 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 standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by section one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that cffect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of sections forty-five, forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two. and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46. Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the selectmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that such body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the clerk of the town for registra- tion. The person to whom the permit is so given and the physician certifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner of cause of the death, which the clerk or registrar may require .- Chap. 114, Sec. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable discase, or when any person is found dead. .. - General Laws, Chap. 38, Sec, 6., as amended by Chap. 632, Sec. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114; Sec :. 36. G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1) Attending physicians will certify to such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury These include not only deaths caused directly or indirectly by traumatism (including resulting septicemia), and by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons not disabled by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation .- Precise statement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the occupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no occupation whatever write none.
SPACE FOR ADDITIONAL INFORMATION
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE. RANK, RATING ORGANIZATION AND OUTFIT. SERVICE NUMBER
X PLACE OF DEATH
Suffolk
(County) Winthrop
(City or Town)
49 Walden St.
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
No.
Elizabeth Lazzaro
2 FULL NAME
(If deceased is a married, widowed or divorced woman, give also maiden name.)
49 Walden St.
(a) Residence.
No
(Usual place of abode)
St.
(If nonresident, give city or town and State)
Length of stay: In place of death
years
months
days. In place of residence.
... years.
months.
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
March
20,
1958
(Month)
(Day) ≤
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
955, to MARCH 19
58
I last saw h.
alive on
MARCH 19
.. , 19.5 8, death is said to
have occurred on the date stated above, at
2 A. m.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
INTERNAL HEMORRHAGE
(a)
INTERVAL BETWEEN ONSET AND DEATH
8 months
PERSONAL AND STATISTICAL PARTICULARS
8 SEX female
9 COLOR
white
10 SINGLE
MARRIED
WIDOWED
or DIVORCEmarried
(write the word)
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE of
Salvatore Lazzaro
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
54
AGE
Years
Months
.Days
If under 24 hours
_Hours _._ Minutes
13 Usual
Occupation :
housework
(Kind of work done during most of working life)
14 Industry
or Business:
own home
15 Social Security No.
16 BIRTHPLACE (City)
(State or country)
Plymouth, Mass
17 NAME OF
FATHER
Henry Martin
18 BIRTHPLACE OF
FATHER (City) (State or country) Germany
19 MAIDEN NAME
OF MOTHER
Lena Winter
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
Germany
21
Informant
Salvatore Lazzaro
(Address)
40 Walden St. Winthrop
I HEREBY CERTIFY that a satisfactory standard certificate of death was filled with me BEFORE the burial or transit permit was issued:
1 (Signature of Agent of Board of Health or other)
J
3/21/58
(Official Designation) (Date of Issue of Permit)
-
PARENTS
(Signed).
Vincent Butts
, M. D.
244. Meridian St. E. B.
Date 3/20/ 58
19.
6 Holy Cross 6
Malden
Place of Burial or Cremation March 22City or Town) 58
DATE OF BURIAL
19
7 NAME OF
FUNERAL DIRECTOR
Frederick J. Magrath
East Boston
ADDRESS
Received and filed MAP 2. 1750 19
"That Clark
Registrar)
[(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
PHYSICIAN - IMPORTANT -
‹‹Was deceased a
U. S. War Veteran,
if so specify WAR)
no
IONS
TIFICATE
ng DEATH nter one each and (c)
not mean / dying, t failure, It means r compli- caused
if any, rise to (a), under- : last.
(b)
Due To CARCINOMA OF THE LIVER
Due To (c)
OTHER SIGNIFICANT CONDITIONS
CORONARY INSUFFICIENCY 6
months
Was autopsy performed?
NO
What test confirmed diagnosis? OPERATION FEB. 28 1958
5 Was disease or injury in any way related to occupation of deceased ? If so, specify.
50M-5-57-920345
301A 1
contrib -- but not terminal ion given
pter 137, requires print or ause or eath OD ates.
Registered No.
55
C+C
EXTRACTS FROM THE LAWS OF THE COMMONWEALTH OF MASSACHUSETTS GOVERNING THE RETURN OF CERTIFICATES OF DEATH
C. t 1 0 C
A physician or registered hospital medical officer 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 standard certificate of death, stating to the best of his knowledge and belief the name of the deceased, his supposed age, the disease of which he died, defined as required by seetion one, where same was contracted, the duration of his last illness, when last seen alive by the physician or officer and the date of his death. . . Gen. Laws, Chap. 46, Sec. 9.
A physician or officer furnishing a certificate of death as required by the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the best of his knowledge and belief, served in the army, navy or marine corps of the United States in any war in which it has been engaged, insert in the certificate a recital to that effect, specifying the war, and shall also certify in such certificate both the primary and the secondary or imme- diate cause of death as nearly as he can state the same. For neglect to comply with any provision of this section, such physician or officer, shall forfeit ten dollars. For the purposes of this section and of seetions forty-five. forty-six and forty-seven of said chapter one hundred and fourteen, the word "war" shall include the China relief expedition and the Philippine insurrection, which shall, for said purposes, be deemed to have taken place between February fourteenth, eighteen hundred and ninety-eight and July fourth, nineteen hundred and two, and the Mexican border service of nineteen hundred and sixteen and nineteen hundred and seventeen. G. L. Chap. 46, Sec. 10.
No undertaker or other person shall bury or otherwise dispose of a human body in a town, or remove therefrom a human body which has not been buried, until he has received a permit from the board of health, or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the person died; and no undertaker or other person shall exhume a human body and remove it from a town, from one cemetery to another, or from one grave or tomb other than the receiving tomb to another in the same cemetery, until he has received a permit from the board of health or its agent aforesaid or from the clerk of the town where the body is buried. No such permit shall be issued until there shall have been delivered to such board, agent or clerk, as the case may be, a satisfactory written statement containing the facts required by law to be returned and recorded, which shall be accompanied, in case of an original inter- ment, by a satisfactory certificate of the attending physician, if any, as required by law, or in lieu thereof a certificate as hereinafter provided. If there is no attending physician, or if, for sufficient reasons, his certificate cannot be obtained early enough for the purpose, or is insufficient, a physician who is a member of the board of health, or employed by it or by the seleetmen for the purpose, shall upon application make the certificate required of the attending physician. If death is caused by violence, the medical examiner shall make such certificate. If such a permit for the removal of a human body, not previously interred, from one town to another within the commonwealth cannot be obtained early enough for the purpose, the certificate of death made as above provided and in the possession of the undertaker desiring to make such removal shall constitute a permit for such removal; provided, that sueh body shall be returned to the town from which it was removed within thirty-six hours after such removal, unless a permit in the usual form for the removal of such body has been sooner obtained hereunder. If the
death certificate contains a recital, as required by. section ten of chapter forty-six. that the deceased served in the army, navy or marine corps of the United States in any war in which it has been engaged, such recital shall appear upon the permit. The board of health, or its agent, upon receipt of such statement and certificate, shall forthwith countersign it and transmit it to the elerk of the town for registra- tion. The person to whom the permit is so given and the physician eertifying the cause of death shall thereafter furnish for registration any other necessary information which can be obtained as to the deceased, or as to the manner or cause of the death, which the clerk or registrar may require .- Chap. 114, See. 45, G. L., (Tercentenary Edition).
Medical examiners shall make examination upon the view of the dead bodies of persons as are supposed to have died by violence, or by the action of chemical, thermal or electrical agents or following abortion, or from diseases resulting from injury or infection relating to occupation, or suddenly when not disabled by recognizable disease, or when any person is found dead. . - General Laws, Chap. 38, See. 6 , as amended by Chap. 632, See. 4, Acts of 1945.
No undertaker or other persons shall bury a human body or the ashes thereof which have been brought into the commonwealth until he has received a permit so to do from the board of health or its agent appointed to issue such permits, or if there is no such board, from the clerk of the town where the body is to be buried or the funeral is to be held, or from a person appointed to have the care of the cemetery or burial ground in which the interment is made.
Chap. 114, Sec. 46, G. L., (Tercentenary Edition).
RULES. OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ing rules of practice:
(1) Attending physicians will'certify to, such deaths only as those of persons to whom they have given bedside care during a last illness from disease unrelated to any form of injury.
(2) Board of Health physicians will certify to such deaths only as those of persons who, though disabled by recognized disease unrelated to any form of injury, have died without recent medical attendance or whose physician is absent from home when the certificate of death is needed.
(3) Medical Examiners will investigate and certify to all deaths supposably due to injury. These include not only deaths caused directly or indirectly by traumatism (including resulting , septicemia), and- by the action of chemical (drugs or poisons) thermal, or electrical agents, and deaths following abortion, but also deaths from disease resulting from injury or infection related to occupation, the sudden deaths of persons, not disabled>by recognized disease, and those of persons found dead.
Statement of Cause of Death .- Physicians: see explanatory instructions on face side of standard certificate of death.
Statement of Occupation." Preciseistatement of occupation is very import- ant, so that the relative healthfulness of various pursuits can be known. Make some entry in this section for every person aged 10 years or over. If the oeeupa- tion had been given up or changed, or if the deceased had retired from business, report the kind of work done during most of working life even if retired. Children not gainfully employed may be returned as at school or at home. For a woman whose only occupation was that of home housework, write housework. For a person engaged in domestic service for wages, however, designate the occupation by the appropriate terms, as housekeeper-private family, cook-hotel, etc. For a person who had no oceupation whatever write none.
U
SPACE FOR ADDITIONAL INFORMATION
I
DATE OF ENTERING MILITARY SERVICE
DATE OF DISCHARGE
I
RANK, RATING
(
ORGANIZATION AND OUTFIT
U. SERVICE NUMBER
O t a e S d F 0 T d n SI ( ir h S1 p
0 0 SI a TE n la P e 0 a C P t P t
f.
-301A 1
PLACE OF DEATH
Suffolk (County)
Winthrop (City or Town)
The Commonwealth of Massachusetts EDWARD J. CRONIN SECRETARY OF THE COMMONWEALTH DIVISION OF VITAL STATISTICS
STANDARD CERTIFICATE OF DEATH
To be filed for burial permit with Board of Health or its Agent.
56
St. (give its NAME instead of street and number) No.
Frank Parker Brown
(If deceased is a married, widowed or divorced woman, give also maiden name.)
11 Please DX
St
"Lunchsol,
(If nonresident, give city or town and State)
Length of stay: In place of death
years
months
days. In place of residence.
.years.6months.
.days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
March
22
1958
(Year)
(Month)
(Day)
4 I HEREBY CERTIFY,
That I attended deceased from
19_
to.
19 __
I last saw h ..... alive on
19., death is said to
have occurred on the date stated above, at
9:10 Pm.
DEATH WAS CAUSED BY : IMMEDIATE CAUSE
(a)
Natural Causes
INTERVAL BETWEEN ONSET ANO DEATH
Due To Presumably Coronary
(b)
Occlusion
Due To
(c)
Arteriosclerotic Heart
Disease
Years
Was autopsy performed? no What test confirmed diagnosis? post mortem judgement
5 Was disease or injury in any way related to occupation of deceased? no
If so, specify
(Signe Arthur C. Murray M. D. Winthrop Board of Heart 22 March 1958 (Ad
6 Woodlawn Cem ... Place of Burial or Cremation
DATE OF BURIAL
March 26,
58
L.E. Parker
ADDRESS
Received and filed. SAP 20 1058 19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Maãª
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCED
Single
10a If married, widowed, or divorced
HUSBAND of
(Give maiden name of wife in full)
(or) WIFE o
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE
90Years.
Months.
Days
If under 24 hours
Hours .....
Minutes
13 Usual
Occupation :
Printer
(Kind of work done during most of working life)
14 Industry
or Business:
F.P.Brount Co.
15 Social Security No.
East Boston
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
William H.Brown
PARENTS
18 BIRTHPLACE OF
FATHER (City)
Alarvik
(State or country)
Norway
19 MAIDEN NAME OF MOTHER Mellica Morgan
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
East Boston
Mass .
21 Henry H.Brown(brother)
Informant
(Address)
Il Moore St. , Winthrop, Mass.
I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial or transit permit was issued: Harpic C. Jerequis x (Signature of Agent of Board of Health of other)
3/25/58
(Official Designation) (Date of Issue of Permit)
TIONS 1
RTIFICATE
ing DEATH enter n one each and (c)
not mean of dying, rt failure, It means or compli- h caused
if any, rise to se re
(a), under- last.
contrib- h but not e terminal tion given
apter 137, , requires to print or cause or death on Icates.
SOM-5-56-917573
7 NAME OF
FUNERAL DIRECTOR
726 Saratoga St. ,E.Boston
Everett Mass
(City or Town)
Braumarktest Nome
Registered No.
[(If death occurred in a hospital or institution,
2 FULL NAME
PHYSICIAN - IMPORTANT
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