Brayton, George STATE OF NEW HAMPSHIRE Burial Permit No.
• - -- BURIAL—TRANSIT PERMIT City or
Town of Rye
•
17' Full name of deceased George W. Brayton
COI
14 Place of death Rye TWaciagr/Wa .New..Eampabire
0 (Town or City) (County) (State)
O Date of death ..t7.13X1g 12 19.7.5 Color 1611xite Sex Male Age 70
I-. (Yr. Mo. Days)
„., Cause of death Coronary Heart Dis9apq
Method of disposal Burial Fiae.yiew .Cznetery
(Whether burial, cremation, transportation, storage, etc.) (Cemetery or Crematory)
91
cd Town or City Rena Fills County State .New. Mark
>. A certificate of death having been filed as required by the laws of this State, permission is hereby given
to Regan,..&.Denrky...Finaeral...1-1.ame Address .Quaker..lid....,. Glens...F.a.11s,...N. Y..
9. (Funeral Director)
2 to dispose of b dy of alsli de se4 as above sated. Date Issued June 12, 1 975
O Sign '1- , .C....7,e.2-24-a?II City or Town of Rye, New Hampshire
u ...
(Town le k -Re • raj Agent City Board of Health)
(-) ••••...
44 • M TE,ir 0 R CREMA Y TOR AUTH . ...L.ORITY S ,• .FILL„OPT,SPAR BELOW
I-. Body was t on Place .(. . 4P-
jeliff74. 19 in
III
rn --------, ... . .(_ a her cremated,, uried4
, or%st
D . .
4-4-4 Section A
Lot No. , Grave No. At..4 Signature
I-.
i" a r pe‘n n c arge)
This permit after being signed by the Sexton or person in ch ge (or by the Funeral Director where there is
ce
44 no Sexton) must be forwarded within six days to the Clerk of the own in hich the burial takes place.
a.
SEE OTHER SIDE
FORM BT 1 3-73-10M
59691
BRAYTON
Lot No. 8 A
Address 2 Glens Falls. N.Y. —(j(:1— ) Section No.
•
Owner George W. Brayton Plot Unadilla Ext.
Date 11/13/72
200 Superficial ft. @ $2.00 per sq. ft.
Location RpVnt9F!ti nn the Nnrth by Vacant, East by Path, South by Road, West by Road.
Corner Posts
Remarks
Deed No. (and changes) 1240
Payment Record Paid in full 11/13/72
Form No. 01
Record of Interments
5
6
'1. 4 r
George Mr. Brayton (6/1h/75)
Margaret M . Brayton 8/18/00 i8
�a 4 /2 N
-L I
1
MAMA, George W.
Age: 70
Cause: Coronary
Lot Owner: George W. Brayton -
Lot # 8 A, Madill* Plot it.
Grave # 3
Case: Concrete
Died: 6/l2/75
Interred 6/14/75
Undertaker: Regan & Denny