Wood, Elmer NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
far 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. 256
Town, Village Registered No.
Dist. No. 198 County Albany or City 113 Holland..Ave.... Albany,....New..York..
(If city, give street address)
Name of deceased Elmer F. Wood Veteran WW-2
(If veteran, give name of War)
Single, married, widowed,
Sex Male or divorced (write the word) Married Date of Death 7/13 19 ....7.Q...
Age 60 Years Months Days Birthplace New York
Cause of Death Respiratory Arrest
Certificate was signed by Richard Lipsky M.D.
Address VA Hospital, Albany,,,, N,Y.
Place of Burial (or Removal) /' tA,Le 4'4. L -- (- -i—4.-r-f
(If body is to be tezP.orarily held, fill)in space l ter)
Cemetery /G"?:t-'..'t.... L. L... .‘. Date of Burial y /.5- 19 2 t1
(If body is to he temporarily ld, fill in space later)
The CERTIFICATE OF DEATH containing the above stated particulars, having been presented to me, after careful examination, the
same Appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same for registra•
tion, have recorded it in my Local Record with the above stated Registered Number, and on the basis thereof I HEREBY GRANT A
PERMIT
to Sullivan & Minahan, Inc. 67 Park St., Glens Falls, N.Y.
(Name) (Address)
the Undertaker to hold temporarily Inte the body
(Undertaker or person having charge of corpOse) (Int , rem e, o otherwis dispo a of tote ow))
Dated 711 19
(Signed)
r Local e guar
This Permit is sufficient for the Removal (and Interment or Cremat'on of a body,! any part of the State (su c" t to cal ce tery or
other regulations), unless removal is by common carrier, in which cas Transit Permit (VS No. 62) is required.
FORM VS. 61. (REV. 6/631 (3A2-323)
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE
OF PREMISES ON WHICH INTERMENTS OR
CREMATIONS ARE MADE
r ) -
Date ot//:f 2! 0‘. was / 19/s
(Interment or Crern- 4
-2 4
C
(Name 1 /
r!;
Section Lot No. //A) -6 Grave No. /
7:2 j47
(Signed)
(Person in Charge)
' -
Address _
-
efr--,/ "1'7
Persorylii charge must return this Permit to the Regist r
of his District within SEVEN (7) DAYS from above date. If no
person is in charge, the FUNERAL DIRECTOR or UNDER-
TAKER MUST SIGN ABOVE STATEMENT, write across the
face of the Permit the words "No person in charge," and
FILE PERMIT WITHIN THREE (3) DAYS with the Registrar
of District in which cemetery is located.
SEXTONS, FUNERAL DIRECTORS ad UNDERTAKERS
violating the law relative to the return of permits are liable to
a penalty of NOT LESS THAN FIVE DOLLARS NOR MORE
THAN FIFTY DOLLARS FOR THE FIRST OFFENSE. The
law will be enforced. Local Registrars are required, under
penalty, to report violations thereof.