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Hunt, John NEW YORK STATE DEPARTMENT OF HEALTH OFFICIAL BURIAL (OR REMOVAL) PERMIT 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 CER- TIFICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. Registered No. 328 Alban Town. Village 1 ,, . C il and Avenue Albany NY Dist. No. - County y or City (If city, give street address) Name of deceased John T Hunt Veteran ?J`f_2 (If veteran, give name of War) _ ale Single, married, widowed, harried /23/ 7 Sex or divorced (write the word) Date of Death 19 Age 42 Years Months Days Birthplace Vermont Cause of-Death Intercersbral betzgrxhag.e Certificate was signed by Paul Jaffee M.D. Address VA Tic spit al_ \1.. "77 Place of Burial (or Removal) Qu eensbwry,,_)ile:Ia.:yo>rIc (If body is to be temporarily held, fill in space later) Cemetery St• Al)11 1 `t1S Date of Burial 8/28f 19 67 (If body is to he 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 Regan & Degny...k:ung.ra ,.. .sryjce.,Znc.„ 341 Glen Street,...Qlens Falls, N,y, Untie•.take_ (Name) (Address) the to hold temporarily and Tnter the body (Undertaker or person having charge of corpse) ;'j' (Inter'r ove, or o r ise digpop of [state howl) Dated /.241 19..6Z. (Signed)...=_ .//. .: . .:4 -2 Local Registrar 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, 82) is required. Form VS. 61, (Re, 6/63) (3A2.323) ENDORSEMENT OF SEXTON OR PERSON IN CHARGE OF PREMISES ON WHICH INTERMENTS qR CREMATIONS ARE MADE Date of was 2 19_ (Interment or Cremation) (Name of C etery, Crematorium, etc.) Section-- t3 Lot No Grave No.___� (Signed) (Person is Charge)) 7Je Address „.. 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 UNDER- TAKER 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 Dis- trict 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 required, under penalty, to report violations thereof.