Stone, Edwin NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
tgr 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.
102 Albany Town, Village Cohoes Registered No. 27
Dist. No. County or City Edwin J Stone (If city, give street address)
Name of deceased Veteran yes
(If veteran, give name of War)
maleSingle, married, widowed,
Sexor divorced (write the word) Date of Death ..Fe.b 16 19 .6.9
Age 43 Years .Months Days Birthrlace New York
Cause of Death Acute myocardial infarction
Certificate was signed by DR James H Mitchell, 3rd M.D.
Address Cohoes N Y
Place of Burial (or Removal) Glensfalis N Y
(If body is to be temporarily held, fillAn spgcte l tgr�honsus Feb 18 69
Cemetery Date of Burial 19
(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 examination, the
same appearing to be COMPLETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same for registra•
tion, have recorded it in my Local Record with the above stated Registered Number, and on the basis thereof I HEREBY GRANT A
PERMIT
to Fitzgerald mFun.e.r.a.l....Home (Address).oh.a.e.s....NY
the �Und)ertaker to hold temporarily and inter 7 the body
(Undertaker or person having charge of corpse) - `(Inter, remo e, orergise dispose of (state how))
Dated I��. Feb 17 19 ..6.9 (Signed) .- 1-.0/
Local Rerar
This Permit is sufficient for the Removal (and Interment or Cremation)of a body to any part of the S 4e (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. 6/631 13A2-323)
ENDORSEMENT OF SEXTON OR PERSON IN CHARGE
OF PREMISES ON WHICH INTERMENTS OR
CREMATIONS ARE MADE
Date of ( I rib/ wri± was ,tit .ja 19 61
(Interment Via) V
(Name of C metery .)
Section ROL k Lot No. 16 Grave No.
(Signed)
(Person in Charge)
Address 7PrU' r,P^ .: /vy
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 District 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.