Cary Sr, G Lucius ••,w.rY ...... ,4 -_rrs..L aaritswY.'.:s+w ....�. a rerWwow..vryw..xaw`a....a .. .4. »r,. ..w.e..,....— w,.. -.-.+�.,- .... �:.:...:...w.«r.,..,.,.:n..• a
NEW YORK STATE DEPARTMENT OF HEALTH ri
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, •
Vilrage, 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. Registered No. 688 •
•
Town, Village
4102 Renss. g Troy
Dist. No. County or City
r
(If city, give street address)
Name of deceased G. Lucius Cary Sr Veteran No . .
(If veteran, give name of War) -
Single, married, widowed,
Sex Male or divorced (write the word) ...marr.ie.d. Date of Death 8- 25 19 7.•6. 1,
Age 71 Years .Months Days Birthplace N...Y..
Cause of Death Cexebr.o-vas.c.ia),az accident
Certificate was signed by .Song Shite Choi, M. D. M.D.
Address $ Princess Lane, Loudonville, N.Y.
Place of Burial (or Removal Glens Falls N.Y.
(If bo4y is toAq enpS r t"i�11�d, ( 4! in space later)
Cemetery i s Friends Date of Burial 8 27 1976
(If bo,:y is to he temporarily held, fill in space later)
The CEf2TiFICATE 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• •
Lion, have recorded it in my Local Record with the above stated Registered Number, and on the basis thereof I HEREBY GRANT A
PERMIT
.o Dunn Funeral Home 319 Park Ave. , Mechanicville t N.Y
(Name) (Address) •
the Richard Marinello to hold temporarily and ,,,. Inter the body
(Undertaker or person having charge of cor e) (In e , remove, " other t e is of (state how))
33 . +
Dated A.v.gus.t.....2.R 19 .....�0.,....., (Signed) .,.Q1.-( ,w
Loca egistrar •
This Permit is sufficient for the Removal (and Interment or Cremation)of a body to any part of the State (su e t to local l cemeteryor
other regulations), unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is require ,
)"t)ltaf VS. 61. (1(KV. 6/63) (A2-248)
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