USA > Massachusetts > Suffolk County > Winthrop > Town of Winthrop : Record of Deaths 1958 > Part 87
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CERTIFICATE OF DEATH
Registered No.
52
2 FULL NAME
Ellen R. Sullivan
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a)
Residence. No.
(Usual place of abode)
59 Cottage Park Rd.
St
(If nonresident, give city or town and State)
Length of stay: In place of death. 2 years. months. days. In place of residence 4 .. years months. .days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
December 12 1958
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
May .14
19 55
to
December 12 158
I last saw Hexalive on
December 10 1958 , death is said to
have occurred on the date stated ahove, at 8:35am.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
Arteriosclerotic Heart Disease
(a)
INTERVAL BETWEEN ONSET AND DEATH 5 yrs.
11 IF STILLBORN, enter that fact here.
12
AGE
83 Years.
Months ....
Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :.
At Home
(Kind of work done during most of working life)
14 Industry or Business:
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country)
Mass
17 NAME OF
FATHER
James Sullivan
PARENTS
18 BIRTHPLACE OF
FATHER (City).
(State or country)
Ireland
19 MAIDEN NAME
OF MOTHEREllen Gilfeather
20 BIRTIIPLACE OF MOTHER (City) Boston (State or country) Mass
21 Madeleine Cochrane
Informant. (Address) 59 Cottage Park Rd. Winthrop I HEREBY CERTIFY that a satisfactory standard certificate of death was filed with me BEFORE the burial of transit permit was issued: Kalkh E (Signature of AgentsBoard of Health or other)
HO:
Nec 15-1958
(Official Designation )
(Date of Issue of Permit)
X
ONS
TIFICATE
ng DEATH nter one each and (c)
not mean dying, ·failure, It means compli- , caused
if any, rise to (a), under- last.
-
(b)
Due To Generalized Arteriosclerosis
over 5 yrs.
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? No
If so, specify'
(Signed). M. D.
27 Bennington St.,
Date .... Dec.12 ..... 19 .. 58 ..
Holyhood Cemetery Brookline Mass
G Place of Burial or Cremation (City or Town)
DATE OF BURIAL
December 15 19.58
7 NAME OF
FUNERAL DIRECTOR
Arthur J. O'Maley
Winthrop Mass
ADDRESS
Received and filed.
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Female
White
9 COLOR
10 SINGLE
(write the word)
MARRIED
WIDOWED
or DIVORCEDSingle
10a If married, widowed, or divorced
HUSBAND of ... ,
(Give maiden name of wife in full)
(or) WIFE of.
(Husband's name in full)
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
"(If death occurred in a hospital or institution,,
St. { give its NAME instead of street and number)
No. ..
125 Cliff Ave
To be filed for burlal permit with Board of Health or its Agent.
301A 1
contrib- but not terminal ion given
apter 137, requIres o print or cause or death on cates.
100M· 11.55.916145
Boston
(Address)
Revere-51 Mass
C
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- te ·n, 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 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
OFFin
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 he obtained as to the deceased, or as to the manner or 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 disease, or when any person is found dead. ....- General Lawe. 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 for the funeral ia 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. TI4, 46. G. L., (Tercentenary Edition).
RULES OF PRACTICE
The fulfillment of the purpose of these laws calls for the observance of the follow- ang 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 infury.
(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.
duLla Medidai Etaminers will investigate and certify to all deaths supposably 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
× 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.
Registered No.
253
f(If death occurred in a hospital or institution, St. (give its NAME instead of street and number)
2 FULL NAME
Cosmo A. Cafano
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No.
12 Taylor
St.
Winthrop, Mass.
(Usual place of abode)
(If nonresident, give city or town and State)
Length of stay: In place of death ...._____ years.
months
days. In place of residence. 1 ...
years
6
months.
days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
DEATH
Jec.
15- the
1958
(Year)
(Month)
(Day)
4 I HEREBY CERTIFY,
That I attended deceased from
11-16
1900, to Dec. 15
1958
I last saw hikmalive on
Dec ó
19.0.1%, death is said to
have occurred on the date stated above, at
6:40 Am.
INTERVAL
BETWEEN
ONSET AND
DEATH
mini
(b) Due To thero sclerosis
Due To
(c)
obesity
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
, M. D. (Address) 94 Waskanye Da 12-1/ 1950
6 Holy Cross Place of Burial or Cremation
Halden
(City or Town)
DATE OF BURIAL
Dec. 18,
19.58
7 NAME OF
FUNERAL DIRECTOR
DiPietro & Vazza
ADDRE
11 Henry St, East Boston
Received and filed
NEC IN 1998
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED Married
or DIVORCED
10a If married, widowed, or divorced
HUSBAND of
Alice Russo
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
AGE 43 Years
Months
Days
If under 24 hours
Hours ..... Minutes
13 Usual
Occupation :
Shop Analyst
(Kind of work done during most of working life)
14 Industry
or Business:
Shipyard
15 Social Security No.
Can't Be Learned
16 BIRTHPLACE (City)
(State or country)
Mass.
Boston
17 NAME OF
FATHER
Daniel Cafano
PARENTS
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Italy
19 MAIDEN NAME
OF MOTHER
Mary Ann Pantusco
20 BIRTHPLACE OF
MOTHER (City)
Boston
(State or country) Vass.
21 Peter D. Cafano
Informant
(Address
12 Taylor St, Winthrop
I HEREBY CERTIFY that @ satisfactory standard certificate of death was hled with /me BEFORE the burial or transit permit was issued : Ralph " Seriaums' (Signature of Agenyof Board of llcalth or other)
Health Office
(Official Designation)
(Date of Issue of Permit)
12/17/58
U.B.V
IONS
TIFICATE
ng DEATH nter a one each and (c)
not mean f dying, t failure, It means r compli- caused
if any, rise to (a). under- last.
contrib- but not terminal ion given
pter 137, requires print or ause or leath :ates.
50M-1-58-921876
301A 1
No. 12 Taylor
PHYSICIAN - IMPORTANT
(Was deceased a
U. S. War Veteran,
if so specify WAR)
W.W.II
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
gaute left Ventricular
(a)
Dilatation
grt.
3.5.
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 hy the preceding section or by section forty-five of chapter one hundred and four- teen, shall, if the deceased, to the hest 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 certificatc 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 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, bet 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 onc 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 casc 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 carly 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 hody 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 or 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 disease, or when any person is found dead. . - General Laws, Chap. \38, Sec. 6 , as amended by Chap. 632, Sec. 4, Acts of 1945.
o 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 Be funeral is to Be held, or from a person appointed to have the care of the or cemetery or buttak ground in which the interment is made.
Chap. IT4_ Sec) 46, G. L., (Tercentenary Edition).
- RULES OF PRACTICE
The Fulfillment of the purpose of these laws calls for the observance of the follow- rules of practice :
Attending physicians will certify to such deaths only as those of persons 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 qjury: have died without recent medical attendance or whose physician is absent DIEbm home when the @ nificate of death is needed.
3) Medical Examiners will investigate and certify to all deaths supposably due to lujary. These include not only deaths caused directly or indirectly by traumatismn (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 FEB. 10, 1942
DATE OF DISCHARGE NOV. 30, 1945 RANK, RATING STAFF SERGEANT ORGANIZATION AND OUTFIT 1505 AAF BASE UNIT
SERVICE NUMBER 310 6375/
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 burlal permit with Board of Health or its Agent.
251
(If deceased is a married, widowed or divorced woman, give also maiden name.)
(a) Residence. No ..
90 Main St
(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.25.years months .... days.
MEDICAL CERTIFICATE OF DEATH
3 DATE OF
December 16, 1958
DEATH
(Month)
(Day)
(Year)
4 I HEREBY CERTIFY,
That I attended deceased from
19
I last saw h ........ alive on
19
, death is said to
have occurred on the date stated above, at
5:30 Pm.
DEATH WAS CAUSED BY: IMMEDIATE CAUSE
(a)
Ne tural .Causes
Presumably Coronary Occlusion
r
Artelosclerotic heart
(b)
Disease
Due To (c)
OTHER SIGNIFICANT CONDITIONS
Was autopsy performed? No What test confirmed diagnosis?
Clinical
(Address): Winthrop Bd. of Health 12-16-58
6 Winthrop Winthrop
Place of Burial or Cremation (City or Town)
DATE OF BURIAL December ... 4.
1958
7 NAME OF
FUNERAL DIRECTOR.
Arthur J. O'Maley
ADDRESS Winthrop Mass
Received and filed.
UFC 19 1958
19
(Registrar)
PERSONAL AND STATISTICAL PARTICULARS
8 SEX
Male
9 COLOR
White
10 SINGLE
(write the word)
MARRIED
WIDOWED 143 ]
or DIVORCER rried
10a If married, widowed, or divorced
HUSBAND of
Margaret Ford
(Give maiden name of wife in full)
(or) WIFE of
(Husband's name in full)
11 IF STILLBORN, enter that fact here.
12
78
AGE
Years
Months ....
Days
If under 24 hours
Hours ........ Minutes
13 Usual
Occupation :
Tailor'
(Kind of work done during most of working life)
14 Industry
or Business:
Men's Clothing
15 Social Security No ..
16 BIRTHPLACE (City)
(State or country)
Co Kerry
Ireland
17 NAME OF
FATHER
Timothy J. O'Shea
18 BIRTHPLACE OF
FATHER (City)
(State or country)
Ireland
5 Was disease or injury in any way related to occupation of deceased? no If so, specify .. 19 MAIDEN NAME bothmo@manai. (Signed) M. D. OF MOTHER Johanna Foley
20 BIRTHPLACE OF
MOTHER (City)
(State or country)
21
Margaret F. O'Shea
Informant ..
(Address)
90 Main St., Winthrop
THEREBY CERTIFY that a satisfactory standard certificate of death was fihoywird me BEFORE the burial or transit permit was issued : Ralph C. Jereautor immature of Acth of Board of Health of other) Heatles Officer 12/15/38
(Official Desiguation/ (Date of Issue of Permity
ONS
TIFICATE
ng DEATH nter one each and (c)
not mean dying, failure, It means > compli- , caused
if any, rise to : (a), under. : last.
contrib- , but not terminal ion given
apter 137, requires print or cause leath on cates.
100M-11.55.916145
301A 1
No ..
90 Main St.
2 FULL NAME
Dennis J. O'Shea
{ (If death occurred in a hospital or institution,,
St. ¿ give its NAME instead of street and number)
PHYSICIAN - IMPORTANT L
(Was deceased a
U. S. War Veteran,
if so specify WAR)
19. to.
INTERVAL BETWEEN ONSET AND DEATH
-
PARENTS
Ireland
Registered No.
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.
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