Hunt, Charles I orm 1 .61. NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
vr 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. Registered No.
Village VTown-
.�r t..2
Dist. No. . 0 Count}�1�ca.' .S�U.+1€.:G.SaX'� k'Z.,r .-L
or-E3ty - -(If cite{ give street address)
Name of deceased Char.'.eM..H..Hunt
Single, married, widowed,
Sex.iiaJ.e Color...Mi.hitG.or. divorced (write the word) G.id.olitefi Date of Death. _Aug. ..J..,7 1915....
Age 7z Years...2 Months ..i) Days Birthplace..'5.as.s.4i.c i:.usa t.t.s
Cause of Death....C.o cni.ry....UCius.i.Cn., C.o.r.onary S.c_Les:.esis
Certificate was signed by >iiton..,I....r.e.enbar.g Mom..
Address ?udsQ.n...F a. .5...N....Y..
Place of Burial (or Removal) TO.V; ,. . L1C� B:S1?.1.kry
(If body is to be temporarily held,till in space later)
Cemetery Pine View Date of Burial d €, i Y l .t....
(If body is-to be temporarily held. lilt in space later)
The Certificate of Death containing the above stated particulars. having been presented to me, after careful exami-
nation, the same appearing to he 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 thereof I HEREBY GRANT A PERMIT
toR.ogar.s...&...CarJ..e.t.on...Inc....c.W.I.i.l... c;...rie.t.cn) ...:. iuis.cn .x Ws...lr....
(Name) (Address)
the Unl e.r.taker to hold temporarily and s.. ., the body.
(Undertaker or person having charge of corpse) (Inter, rPmo`e, o er 'se dispose of( tate how])
Dated....AU F., 1 5 19c:5... (Signed).. �/1�'1
Deal Registrar
This Permit is sufficient 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.
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