Gennamore, Frank I1Cry IVKI 4 I A I C YCrAKIMCIIII Vr 17CAL1H
OFFICIAL BURIAL (OR REMOVAL) PERMIT
figEF' 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 CERTI-
FICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK.
Registered No.
Dist. No. __56_01. County Warren or City Glens Falls
If city, give street address)
Name of deceased Frank_.Joseph Gen!).amore Veteran no
(If veteran, give name of War)
Single, married,widowed,
Sex male or divorced (write the word) single Date of Death Mar 24 1976
Age 71 Year�� /y,/7 Months. lays Birthplace Glens Falls NY
Cause of Death `��/ f 4_ 4�-- '�— f (>( t 1, „
Certificate was signed by ( hr Sigmund Weiss M.D.
Address 6 Elm St,,., Hudson Falls, NY 12839
Place of Burial (or Removal) Tn of Queensbury, NY
(If body is to be temporarily held, fill in space later)
Cemetery St Alphonsus Date of Burial 3/27/ 19 76
(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 examination,
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 HERE-
BY GRANT A PERMIT
to Carleton runer.al ?Tolne, Inc. Hudson Falls, NY 12839
(Name) (Address)
the runeral ni_rector to hold temporarily and inter the body
(Unlertaker or per on having charge of core (Intel,'4emove, them eejdiis a oof�(state how))
Dated -(� 19 (Signed) .' -, .� i " "
V Local ea i.-ar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any part of the State (subject to local
cemetery or other regulations),unless removal is by common carrier, in which case a Transit Permit (VS No. 62) is required.
FORM VS. 61. (REV. 6/63) (4A2-179)
ENDORSEMENT OF SEXTON OR PERSON IN
CHARGE OF PREMISES ON WHICH INTERMENTS
OR CREMATIONS ARE MADE
Date of it s.- — was /A 19 74
(Interment or Crematio
aZn
(Name of Ce�(Jetery, Crematorium, etc.)
4 4
Section /7 Lot No. // Grave No.
(Signed) 7 � .
(Person in Charge)
Address 35 / �lLf•� ' 14241.6 24 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 STATEMENT,
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 UNDER-
TAKERS violating the law relative to the return of permits
are liable to a penalty of NOT LESS THAN FIVE DOL.'
LARS NOR MORE THAN FIFTY DOLLARS FOR THE
FIRST OFFENSE. The law will be enforced. Local Regis-
trars are required, under penalty, to report violations thereof.