Finke, August Form vs.ai. NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
Lt This Permit can 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. Town Registered No.
1�.
Village '
Dist. IVo5762 County ;plash. or City Kingsbury
sba.ry
(If city, give street address)
Name of deceased August F. Finke Veteran Yes
Single, married, widowed, of veteran, give name of war)
S lale Color White or divorced (wnte the word) Married Date of Death May 26, 19...61
Age 63 Years Months Days Birthplace Schenectady, N. Y,,
Cause of Death Qcro;iax.y...T 5'RA1baais.
Certificate was signed by F nk..Z1...Ealkenklury.,. M.D.
Address 5.1 fr=15 Falla,..J
Place of Burial (or Removal) Tla......9f... u.e.en5b.Ury...N.... .
(If body is to be temporarily Mid,fill n space later)
Cemetery Fine view Clem. Date of Burial May 29,..1 19
(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 Joseph L. Regan,, Jr, Qlem5..Falls., U.. .Y.
(Name) (Address)
the undertaker to hold tempora ' nd i N• the body.
(Under er or„person having charge o� orpse) p (Inter emove, rwi dispose of[state bow]) y
Dated Play 19 b� (Signed) .. '.:'N... .
Local egistrar
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.
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF
PREMISES ON WHICH INTERMITS OR CREMATIONS
ARE MADE
Date f 'r:. was ,'ac `_T ' 19 (
(Itersent or )/
7 , --(' ___•7
I (Name of Cemetery, Crematorium, 74c.)
/
Section / Lot No.�.S .1 7 Grave No. `-
(Signed) Z!r < / f--- ;% , (f,/
(Person in charge)
Address Z-(7 � i' ( i "'`( < 4. ":.??
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_relativeto 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.