Sanders, Albert Form VS.!IL NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tar This Permit eau 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. lit+ity
Registered No._
L . Ni ,5.601 � �, Warren Glens Falls
(If city, give street address)
Name of eceased ALBERT J. SANDERS Veteran No.
Single, married, widowed (lf veteran, give name of War)
Sex Yale ColorWhite or divorced (write the word) Widowed - of Death...0c.t.Qhe.x 11)..19..56.
Age 90 Years — Months "' Days him, ce Tn. of .Queensbury, N.Y.
Cause of Death Biliary Cirrhosis of Liver.
Certificate was signed by George F. Nolan M.D.
Address Glens Falls, N. Y.
Place of Burial (or Removal) 1n Town of Queensbury, N. Y.
(If body is to be temporae_ykins11 f.,spaete�
Cemetery sdJ 71 Date of Burial October 13 19.56
(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 exami-
nation, 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 thereof I HEREBY GRANT A PERMIT
to H. Edmona Brous Lake George,, N. t
�(� (Address)
the undertakei''ame) to hold temporarily and inter -^ the body.
(Un er ke or perso h ving charg corpse) (Inter,re �e,oy o se dim se of [state how])
Dated veto oer 143 19 74u (Signed)
Local 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.
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF
PREMISES ON WHICH INTERME/iTS OR CREMATIONS
ARE MADE
•
Date of was � ' /- 19 J Sc'.
(Interment or4Cremstion)
(Name of Cemetery, Crematorium, etc.)
Gam.
Section Lot No. Grave No.
(Signed) .��cL- ("14'2t C �(
(Person in charge)
address
Person in charge must return this Permit to
the Registrar of his District within SEVEN (7) DAYS
from above date. If no person is in charge, the
FUNERAL DIRECTOR or UNDERTAKER MUST SIGN ABOVE STATE-
MENT, 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 and 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 re-
quired, under penalty, to report violations thereof.