Baccari, Anna 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 CERTI-
FICATE OF DEATH, LEGIBLY WRITTEN IN DURABLE BLACK INK. 60
Registered No.
Dist. No. 5932 County Westchester oToCnyVillage North Tarrytown
it
If city, give street address)
Name of deceased Anna Baccari Veteran
(If veteran, give name of War)
Female Single, married,widowed, Married Feb . 26
Sex or divorced (write the word) Date of Death 19
Age 80 Years Months Days Birthplace Vermont
Cause of Death Massive myocardial infarction
Certificate was signed by Bruce Heckman M.D.
Address Ossining; N.Y.
Place of Burial (or Removal) Glens Falls, N.Y.
(If body is to a temporarily held, fill in space later)
Cemetery fineview Cem. Date of Burial March 1 19 77
(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 Waterbury & Kelly Ossiaing_,____TZ -Y
(Name) (Address)
the undertaker to hold temporarily an inter t body
(Unlert a or pe having charge of corp it r remove, or otherwi is f (state how)
Dated reD • Lo 19/7 (Signed) --
Local egistrar
This Permit is sufficient for the Removal (and Interment or Cre ation) of a body to any art 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) )6A2-130)
ENDORSEMENT OF SEXTON OR PERSON IN
CHARGE OF PREMISES ON WHICH INTERMENTS
OR CREMATIONS ARE MADE
Date of- 4.1'-'`-1- -1-1--e-was )24"1/2.-, / 19 7/'
(Interment or Cremation)
l
e ��_f
(Name of Cemetery, Crematorium, etc.)
it'
1 I k.�( /�/4 C(/ .i / ,i /
Section Lot No. -) , (- Grave No.
(Signed) \-\4'l'Z `� /' '
Cj (Person in Charge)
Address ie, r r •
j
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.