Welch, Walter NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
rar This Permit can be signed only by the Local Registrar (Deputy or subregistrar)of the Primary Registration District (Town,
Vilfage, 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.
Town, Village Registered No. A. 1
Dist. No. County -- -„rsa--., - or City
(If city, give street address)
Name of deceased '\.1:-L-. '- %•\ t �`_,A-s:.� �-\,- Veteran 0i `
(If veteran, give name of War)
Single, married, widowed, - ;
Sex �\j \ , r or divorced (write the word) 'y `, '1 :i\.?s-� Date of Death ..' Lc.),,,,_{� s� ) 19 ..7.: .
i Ells
Age i Years .Months t Days Birthplace... �1.�
Cause of Death �.. ,. ' ' .�"'� ::! V ,.v`'N^
Certificate was signed by L 4..,.===-A- \� >L-rv°° `(`lc.='yam-`�- .) M.D.
Address G.L. -a `i.-t -
Place of Burial (orRemoval) ��....
(If body is to be-temporarily held, fill in space
.ace later)"
Cemetery u`,.--+- '\,..?:,.. ,.....3 c:. v,---� r Date of Burial �5.� 19 3
(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 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
PERMI
(Name) (Ad&ress))'''''' �"
the L....KAN - -�Sf' to hold temporarily and ° -a- the body
(Unde aker or person having charge of corpse) (Inter, remove, or otherwise dispose of (state how))
Dated 19-' (Signed)
oc i d
This Permit is sufficient for the Removal (and Interment or Cremation)of a o t ny"prart of hate (subject to local cemetery or
other regulations), unless removal is by common carrier, in which case a Transit Perilj✓it(VS No. 62) is required.
FORM VS. 61. (REV. 6/63) (A2-248)
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE
OF PREMISES ON WHICH INTERMENTS OR
CREMATIONS ARE MADE
f• _
Date of ' ' `, ,. ,, was � .'• t 19 )
(Interment or Cre ci+n�
(Name of Cemetery, �eena-ruriu'm; etc.)
Section Lot No. .\ Grave No.
(Signed) \
(Person in Charge)
Address
Person in charge must return this Permit to the Registrar
of his District within SEVEN (7) DAYS horn 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 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 required, under
penalty, to report violations thereof.
WELCH
Lot No. 1081
kddress VanDusen Rd. , West Glens Falls, N.Y. Section No. 22
)wner Walter Welch Plot Uncas
)ate December 31, L968
100 Superficial ft. @ 1.50 per s q. ft.
vocation Bounded on North by Path, East by Path pnd lot of Dutson, West by
Vacant, South by Path.
corner Posts
remarks
)eed No. (and changes) 1081
ayment Record Paid in full December 31, 1968
1
'Form No. 01
Record of Interments
�►� • Co-01-18
Edward J. Hill Sr r (6/23/78) CiOYCE -*ilk.• +i 'a a ND1 l0-
Qom
Walter E. Welch (7/23/73) -wbfl Ti n��t1,� J/, ii Co 3o�a'J �`'� j,•�a
to i�8
�
I Florence Welch 1a •28•L-t; - 7
SL,aw r5 c_1(o, l43 L( -' - aS'- $ ! 8 I
3•aA-8(c
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WELCH, Walter E.
Age: 6L tgr:
Cause: Myocardial Infarction
Lot Owner: Waliber Welch
Lot # 1081, Sec. 22, IIncas Plot
Grave # 2
Case: Concrete
Died: 7/23/75
Interred 7/25/73
Regan & Denny
Undertaker: