Hubbell, Emeline Form VS 61. 6-8-34-50,000 (17-7901)
NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
OW This Permit can'be signed only by the Local Registrar (Deputy or Subregistrar) of the Primary Registration District (Town,
Village, or City) in which the death occurred after the FILING and acceptance of a CORRECT AND COMPLETE CERTIFICATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. •
Dist. No. 5 6... 7 Registered o.
Town "(
County Viftge
(If city,give street a dress)
Name of deceased
Sex1�J� .Single,married,w' owed,
2letolor ..or divorced (write�t/he word)... Date of ath.. �- 19...3.
Age Years his LL...........Da Birthplace
Cause of Death l
j�
Certificate was signe b �` L�:^ .? , M.D.
Address r T7 �--2 .- •
Place of Burial or Rem val) 7.44.7
•
I • •• - •-•
(If body is to be temp ril held, in space later)Cemetery . C �� Date o: Burial ,9.3.,
(If body is to be temporarily held,h in space later)
The Certificate of Death containing the above stated particulars, having been present d to me, after careful examina-
tion, the same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW,
I have accepted the same for registration, have recorded it in my Local Record with the above stated Registered Number,
and on the basis t of I HEREBY GRANT A PERMITto..7 WI e..0•W,C.4.re.0 ide7 , ---1.--et4.4„.0 ] n
ame (Addres
7
the to hold temporari d '.... ,.�....,.... the body.
( nderta or person'having charge copse) A (Inter,re ,or o ie�s{i e of t to ow]). , !
Dated 19..2 (Signed) _. .. c f'
Local Registrar '
This ermit is ufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local cemetery
or other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
Oa 0 a,0 ^wm I-, co ti .. w a.
O.o a O cd O cd.y' s0. O v td 00. 0 rn - 0. . .50U.. 0 U v, a w i'' . 0 id,.g Cn a s '' 0 m''''..0
a m O,Q 7r i.�;�n.- 0 C4
( C/ z a0i rn > C3,' - O �...w. . , ,. ... °....0 �,'--+.+ O O ate+ O vai °.��Ov� O•..'b ti OCG d
W � � �" y o °.� ° 0^w�iaa a cd a�i N t°. >�� bA� o .sue a a a� cd 0 3 AO
�wbd a° ai� � t" o, °v an; v.c u •a�cs °•,-, . " �a � o ° o ' ° °' � 3 • va3 . �; °
Off' >a4. y t.m2 cd a°� t�.'0. a P,,- .0 0a �� ova vaa ° Cad U 6 a3pp "c�aa � 0`
Q p �, t.Y .� T .O}, -0 t. „ as
cd t.y .,,, .a a., O °,� CL P,a.. t.a. vi „ '.., a .,, a G. cd..,b a Ci
w W 3 x cV,L' p a a m a w '+ 'n+'O YO. v� s' c"�' aa+w'C ate".: `- p,0i•aa vai U a �. U' 0 O1 0 0'
(, a.ui m ,,.0... m O ,n O '. 0 a. I.... O O an w t, •.L" a O a
3� � 3 o p* va � bo r. , � c� aac'"io. aooaa° aa� ° � a'"i � y� 000a' °� as Asa Viz .
„H r/� ,Dy m .�.� ap^'b �...� � aa1y ab9 .�. a yVia, �pyaa�-+ cd � g.r OV�.:vw
a -c7•a abi bOA ° T.-, �.~ o aar caiy'v, 9 b4 �" ~ .O.s7 ta. Ms.,
� 0 y cd 'z ..,
TT u 0; 4,4 ,. .�... c�.y °.�, a cd ,.,„ Y.... .-. O a .a. P, .., a "CG a m
V • W•E< 1� O.ia'. o T7 O TO 0 N.,"'. 0':w Ia. 0.. 0 .
in '.. t, bA T> 'b y t0 a 7T. .0..^c3 ° E ')..0 0.0..' ~O Ci,0 >Q1' 3 0
C/� AzL.A a.' 0,Z -0s-. �,bT..10 � dye y61 41.0.2z" H ..`n. 0 � o ° t -1m '677ma., T,-.,may a+ava.+
y�j a 'U... p,... T,ay,b t. a.b id a, +. w �. .k a t. +-' p,.ty M 0 p,v, 4, O,-°., ,., N 01-0 b b cd., .0.
,�-1 H ,s". cd'C b v.G O �. O t. a a O... a a a s rn a.-, a °... '$ d O Da m
a v O O 0.0 ,, cn,p ni cd t. a-, v a ° ° U
" d,m `r.1 c'+ a a.0 �, ..Q w cd u) a U a t.N a G''y t..-, a ar.0 ,0"0 a _rn 0,....... 0.1),.......o "..a, i''A,•l' 0
Fa - "4 t4041- [-y '- ,n a a o, °b a,.0 a'y cn� '.,� dc'i.�. 0 0 8- ezi,'' a O." 1.w ,n- 0 > .a 0...� [r,0
W ,mow a"� (/7 .� Q'.� a..' cd..^, a a.-, y �, -0 a. cd t. ° v a. i~ Cy.C.,. p•-+ cd a.
O o W gb ward ma.. ° ,. > b acd "y °bAot. Ea.) c, .� o a °' o
++W 1"4 0, 0 t. cd ,n U v - a , .., O U a ., a ti v a a
.r u i+ Oi O a >' >>v �'�.''b m O h u'�."' U N 0,- O 0 x O X as cd •> y P,� ' P.,+a' m P a U,bA , P,U as H W 0
�i cd bA g 'C O.0:-. :n.-.'d... `4-'- ° ..•- O v, .al.'.v, cd.- a ,. 0 .Ss(3.c/�•ra
_ a i. M O w a i:, act, ,., y. c3 cn cd a+ a y.M y �r a a t. ''-' A > O a ,a.
W H a.t 0 W cda a -0 cd d U t.-0 •n ... .0 p T"-' cd 3 'c7 T 0 a... ..
.% %E, E•, a t. ,..p v 0.0 0 a ,n,-[ 0.0 ...,.0 .a, co....,.^ ty.0 a' ,.d 0 a t.w'b p s. bp,. ,,, tt Z,W
WzW ° ooDAi ° � O a cd a., � ,. - py � �. . 0. a 0O.y ,v <w O
uw -C a .0 w 0 ,-, °. 0
.,m a. Q d 7'' y.-. ° .' P,,O id •�' '�u,,�,.-, t:w °r4 0 a O cd••-� , i... .... 0 a y L., cd ,.,,.P id 0 y+,,_,, a'b avi v, E T'+'X W 0a,
Ix��a �_ _ • -c�� ,a. a �3oai ` s Pa o Sao y ErO
o�y t.2,..... w <y r a L1 r4 cd v a.„.,,b ,,. I' O.n U O•'"' t.w o^ti .+.". b a .0 61,C)
_.-, p ," O o 0.0'sv, U .~ a •0 a0.
ri,,,,,,, w .U•-• mH Ey O a,ba "�wcd r.y.0a' p03..O��C x � aa•... >� 03inw� a � ,b.° a--w.Ly a"" � � o ���
H o--- a; C 0 a-,, � R a ,n ,n ..' _ a a _..% m d cn4.). cn
Z rr'.�,Z '' w u O s,a .-, a '' .Z.y... .. y, 0... - .._ y_� .. _ax_ CO y_..._a' 0-o-vd cd a 7q a a�.a 3.
o W v °0' d 01 d O"'b y o�; > a mb�� > ^� 3-to U yid a..Z cd a at . °w a a›,-0 cd y a' a � �•�.0 a W W ca..
(y H Ea' 0. • W E 3p.�ro ct'E '> p 40. s-0 a v; ,�•�•�v'i.,-. z o E,c.8'b a o•F ,,-° o-0- -, bA•E a.c ,'5 [b a
[••, N u•m a, �q,, 0 U .0 -0 p,0 tr a,_.. 0 t. 0 o cd cd U ., m O a 0 0 C O O v .O X a
X 4 V.a 0•y,4 W t, o E'y m v cdd 0 ,.., P a a, 0,-7 t0,•� P,p 0 > cL.a; „dmRI C 0 y 0 tea-- cd doi N'Y d 0 a a.0 Q®�
Q,' v w.. A 0; O 1.,-•.'" > o 0.,cd A ,. cd ° O a cd fd _.N id ,., 7r s'
W'�a o `;14 ou H as v, ~ Od O m d y a, dp0Oa ad > a E., v
(/] u i.'w o s o c7 ° a v °id a "` a a w o in ," o.- ,. ,n 0 s"•: d)v•ai '-. a' C i+ v
Q fit.i-, Q. LLa ,do�� o0i e�b. 'y;id > ,. � Cm ,�6•C• ..COaU .., vbA SS y•.. p,"' y, v,o c�^ aOiyCv' aW o0.' O
'd F .�, '' t.�.. a GA Zi O G-i °... ;?"to .H a t• aid ae0.....- m a..N`n-, GL^, ,. 0 q A cai, O P, ° A 0
Q� z°2a' ;;zm•� 07d � o °a-'C a'•° ,a. °4 2 booty o * `' °Joy'� ,a >, '�.'." 51 gom••^,-. . aow2c`4,. zt®
id O -0.-, v... O a cd `I
CA
U � w ��+ �.t icy.-, poaoa°w° s._#a,' ou; 0 I. a,4:°:.n..r,°„ICO oZ a.�A'3w ° aom w �uda .au
H 1.1 d •II I i... v_'a' r �. cd .mo t. O p t O .0 #* U v o.. 0 0 T.. u, a O cd ° v, t: '. _ 0. 0
> 0 as Vw. aa)i"' t. t, t,,. ,b0).-. - R wwu •a-ltfi, 3 ,+,,, acd t'. •b - u mu•Ly a acd 0 `n tOC y
W[� bAO O Y �•. tav> o a.oaiOa0U•cl.cdcdOy n Oy^O > + cdOa. UO+ cds ° F' 00 . � „�. c bApbAb Al
ai � mF.. 41 a.a '-, �,o-. :np °'> cda • ate, 0°.--1 d. ^, 00.4' acsT"' ^v' s..Ln °. .-, • wC,Cd azy ,01.
W QI '° d.0 E-1 'd U., G Q•v,`*"Ov.� a y.4 02 . ai'd 2g•� aid• aid+ 2), ch... ° fl cd aa,n ct, sa, 0 �^C, ia. a"p cd ° aA cd
V� V O W $ Y�, d 0'v, cd cd p O ., y .''id G"'.''.4-+ 3 0�i 0 P a a bA'� a O 0 �+ �.�'T7 +O+ cd a`ni'L7 ° cd '0"� a U w O„p H
p0 e0 WCa) ° .... `nO C ,,. cd ° o ,., P. bO � Nq 0aa. _,.' 0R a -w... > o o O04 a,
`"a4Q ao � a b. a A a ,. � A . � ca4 c cdp cdcdd .
,tea i. "n.'0.' 0a0 °w.. a +-'� w ,, .0 tvpH >C C) U .00'T t. ro... LLI
1.4 0 QV7 u•a. V1 td'O..0 ta.'�v, ° GLcd,a,{ as ,a. U' a'r" 0 mOiy+"O•'w0 a o pO. °idY.n•.00 y 0 > O 0.) U a'-' o a o tc. 00.,uy'.",
A d o'� t;•H a p ...Z-, a L: P, N.+'.'.J 0'+' v,id cd �^'
w bA Q••••,a C s s a t' o .0,.0 cd•t, > 0 v L\`*' .n O a 03 5, > 0i cd a co cd T,. cd .0 s..0 v m[Li bA
yy O " q t. y a. m 'b O E a y a 0 a m O v M O.� >, WAm... O t.-0.-+ t, '0 P, t» .0't7 w ° t. at
L-, a, O es 0 m y .0 ,n >• aid a, in' .0 U 0 -t7-o�d ,.. 'b E 0 a ,n o,m O cd id'0 ,1-'-. �.r a•bA m 0!,
W aD c_el A,A z O A vn O y 5 o 0_,0 `',-a ° I, E' 51: y.,. `°° bap •� 0.. R. yam+,COD L. ,1 6..5 T OM 0e. •al u. ,8 P,id zbi)0 ta. - 4.4
z
as 0 o al a 3•.. w a•am a a 0 °v c' Tea. cd o ''., o <u
Q cna. �v-jp,o 3 .+..y ,...:. 0-5•" ci'� y.0 °,0y0 A ,. oa,0,4a0 ^y ,. My00 7. Oa t. q�ja0a0s. 0.,>.Z.,4 00" 0
m o >w 3 o t 3 a... av, as v.0 0,a.. m'0...' o 0 0) t,pw o cd,0 0 t.,� 0 ti t, 0.o tw: .., aFa