Garand, Andrew Form VS.St NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tsf This Permit van 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.. -T _ Registered No.... /2'
Village-
Dist. No G Z. County ;� 1-'---2.:,..4. ..yr— or City _.-
let-E4 /2,41. ,./ '' .
C, ,. (If cis give street address)
Name of deceased��?r-Ti`(1i-e-c-c-1 - -*f--i'-e-` Veteran
Single, married, widowed, Of vet an, give `e of war)
Sex ,�/,1 Color l-u or divorced (wnte the word).�21--S-''�` 6: Date of Death 5 19 ).
Age 'F' ' Years Months Da s Birthplace 4----ram -0 4 .�
Cause of Death ..... f
Certificate was signed by " ..<r-•-c-S .. M.D.
Address 'ter,r...... .. .... .. �Y
Place of Burial (or Removal) 2-�-,�'�
(If body is to be temporarily held, I in space later) M
Cemetery `�/,,..::: .., tS�(��r *..z..,. Date of Burial " -I"' 19
(If body is to be temporarily held, fill f i space later)- ,
The Certificate of Death containing the above st 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 statedat Registered
Num , and on the ba is t e�•�of I HE EBY GRANT A PERMIT t: 4....
to
the L --1 ^' _,...' 7' to hold tempo ly and .. t e dy.
(Und r' person having charge of corpse) (Inter,remo e,or o ervrise disco of(stall how])
Dated..:,:. . . 19.. ...�''' (Signed). ��
Local Registrar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State ("abject to local
cemetery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
ENDORS MINT OF SEX'lUN OR PERSON IN CHARGE OF
PREMISES ON WHICH IN l'AD TS OR CREMATIONS
ARE MADE
Date far- �-�CiJ-� 19
(Interment or
(Name of Cemetery, Crematorium, etd.)
Section Lot No. r/ ,5 Grave Noi
(Signed)
(Person in charge)
Address (!.' �G (' 1
79 7/` e-
Person in charge oust 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 OFF'r.NSE.
The law will be enforced. Local Registrars are re—
quired, under penalty, to report violations thereof.
GARAND Lot No. 17-B
Lddress 18 Charles St. , Glens Falls, N.Y.
Section No.
)caner Mrs. Andrew Garand Plot New nenesaw
)ate 9/8/58
Approximately 100Superficial ft. @ 4i1.30 per sq. ft. = 4130.0
.ocation Bounded on n/w by Hewitt lot; on s/w by grass path.
1,orner Posts
remarks
)eed No. (and changes) 720
Payment Record Paid in full 9/8/58
Form No. 01
Record of`interments
5-S a3
A-PAL
Dorothy G_ Garand 7/77/R9
Andrew Garand /-er-5-F ,p
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NAME Garand , Andrew
ULF
Age: 40
Cause: Coronary Occlusion
Lot Owner: Mrs . Andrew Garand
Lot # 17-B Kenesaw
Grave # 3
Case # Concrete
Died: 9/5/58
Interred: 9/8/5 8
Undertaker: Singleton