Bennett, Howard Form vs.EL NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
sr This Permit can be signed only by the Local Registrar (Deputy or aubregistrar) of the Primary Registration District (Town,
Village, or City) in which the death occurred after the FILING and acce of a CORRECT AND COMPLETE CERTIFICATE OF
DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK 433ltill Registered No._...._...._...........
3 301 ONOtsiDAGA liraW SYRACUSE
Dist. No County or City
(If city, give street address)
Name of deceased Rev.Eoward C.Bennett Veteran No
(If veteran, give name of Wee)
Single, married, widowed,
Sex Meae Color..!h.,te or divorced (wnte the word) ifarriet Date of Death..........October..26.,..19..5B..
Age 69 Years Months a s Bi lace Crre.er.wl.Gh,.N..X.
Cause of Death �1`. .. —�e-i.� E' < y ' -:V/44-:1,: t ,,.
Certificate was signed by . Pr4..Rg.ifgA5te.3.ri. M.D.
Address y? 8y3W1?B.R .tI X.,
Place of Burial (or Removal) �t-G--L-s 4 ...�L�"
(If body Is to be mporari]y held, All is■pals later)
Cemetery....;:,' —`�= Date of Burial October 29, 19 59
(If body is to the temporarily held, fill in space iater;'
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 B.Abbgtt ;eAcb, 500 W.Onondega Street,Syracuse,N.Y,
(Name) (Address)
the Undertaker to hold temporarily and �A,t. x the body.
(Undertaker or person having charge of corpse) (Inter,remo�or her d1s?4 of[state howl)
Dated October 27.19..58... (Signed) ett:... /../...4. ..GG.
CEPUTY _leilatru
-72
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any pest of the (eshjeet to local
cemetery or other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 82) is required.
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF
PREMISES ON WHICH INTERMENTS OR CREMATIONS
ARE MADE
Date '2 "1-+-1. -was /�71.4. f 19 c)�
(Interment or cr finis
•
.' '2 . ' ,
(Kaye of Cemetery, Crematorium, etc.Y
Section Lot No. < Grave No.%�n/9
(Signed) -'-/ Cl/L( c ")'1,
(Person in charge)
Address fir" 1G` Zyy,2,-:..t_. .�JL_,,t+- (17/4---
3,‘-. .6
- ��,
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," aid 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.