Bress, Robert NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL OR REMOVAL) PERMIT
This permit can be signed only by the Local Regi trar (Deputy or subregistrar) of the Primary Registration District
(Town, Village, or City) in which the death occurred after t e FILING and acceptance of a CORRECT AND COMPLETE CERTI-
FICATE OF DEATH, LEGIBLY WRITTEN IN DURABL BLACK INK.
Registered No.
Town, Village
Dist. No. 153 County Albany or City Colonie
If city, give street address)
Name of deceased Robert Bress Veteran
(If veteran, give name of War)
Single, marrie idowed,
Sex Male or divorce to the word) Date of Death March 23, 1977
Age 79 Years t s Days Birthplace
Cause of Death Card o.._,. l_ Q_naxy-__Arrest
Certificate was signed by ;_%_ M.D.
Address
Place of Burial (or Removal) St. Alphonsus Cemetery , Glens Falls, N. Y.
(If body is to be temporarily held, fill i• -,ace later)
Cemetery St.Alhon-'. _ • ___Cemetery Date of Burial Apri1-.23.,---. 19...77
(If body is to be temporarily.held, fi •, space later)
The CERTIFICATE OF D At, containing the above stated particulars, having been presented to me, after careful examination,
the same appea ' : o be S •LETE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same
for registration, have •cor! • it in my Local Record with the above stated Registered Number, and on the basis thereof I HERE-
BY GRANT A ' RMI
to ___Parker_--r-Z•>sio Mem-•----Funeral Homo,---Inc, 2013---Broadway,---Mvlt-x-,...N......Y.
(Name) (Address)
the .Edlaar_d.__LAReinfur_t to hold temporarily and tef the body
(Unlerta Trlmer os ilaving charge of corpse 7 I (Inter, re ove, of pose f'state w))
Dated C l G ' 19 (Signed) .s ,� � ----_-
coc 1 Registrar
This Permit is sufficient for the Removal (and Interment or Cremati ) 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 f rre� was O I 19 7 7
(Interment or Crema n) �-�I
(2-
(N e of Cemetery, Crematorium, etc.)
Section LI 4 M Lot No. 6 Grave No.
,
(Signed)
(Perso in Charge)
Address ,� �' ,9Cr-GZ%� • 71
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.