Noreau, Alphonse _ -4*EW YORK STATE DARTMENT OF HEALTH .
OFFICIAL BURIAL (OR REMOVAL) PERMIT
W 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. 5601 Registered No. '357
Warren Town
County Village 26....nut Street,
or City (If city, give street address)
Name of deceased...._._........_..Aa„p ,9I .;?.Q A, Noreau
Sex M Color White ordivor d (write theWidQwed Date of Death Dec 29 19.... 7
Age 76 years 10 Months 14 Days Birthplace Glens Fa 11..$ N.Y
Cause of Death Braieho pneumonia 4 das; cardio vascular disease
Certificate was signed by Dr. Harry Depan M l)
Address
Glens Falls NY'
Place of Burial (or Removal) Town of Queensbury, (Waist Glens Falls)
(If body is to be temporarily held, fill in space later)
Cemetery St. Alphonsus Date of Burial D.e.c 31.,. 19...32.
(If body is to be temporarily held. fill in space later)
The Certificate of Death containing the above stated particulars, having been presented to me, after careful examina-
tion, the same appearing to be COMPLETE. CORRFCT. 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 thereof I HEREBY GRANT A PERMIT
t„ Lionel J. Boivin Glens Falls NY
the Under to hold tempor, IUl Inter(Address) the body.
(Undertaker or person having charge of corpse) emo , o o erwi of [s bow])
)a,.v,t December 30th, 19 3'7 (Signed) __ _ . ._.....
Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation y t any part of the State (subject to local cemetery
- `-or other-regatualions), unless,removal is by common carrier, in which case a r nsit P it (VS No. 62) is required.
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