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Bennett, Jessie O.G.. IVnn JIMIG YGf MRI MEIN Vr nGMLIn OFFICIAL BURIAL (OR REMOVAL) PERMIT EG ' This permit can be signed only by the Local Registrar (Deputy or subregistrar) of the Primary Registration Di.:''rf t (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. Town, Village Dist. No. County Warren or City Tn of Queensburi:N.Y. If city, the street address) Name of deceased ,=Je eel e E. Bennett Veteran 4- (If veteran,give name of War) Female Single, married,widow d, March 7 78 Sex or divorced (write t word) Date of Death 19 Age 8.7 Years Mont 7y Days Birthplace Cause of Death Certificate was signed by i./ M.D. Address Place of Burial (or Removal) �� To );ci,-, ,leen;abury, N.Y. (If body is to be temporarily held, f' space 1 t r) �7 'Cemetery $eelye me 4r -- Date of Burial April 18 19 / (If body is to be temporar' held, fill in sp e later) The CERTIFICAT F DEATH co aining the above stated particulars, having been presented to me, after careful examination, the same appeari to be COMP TE, CORRECT, AND SATISFACTORY AS REQUIRED BY LAW, I have accepted the same for registration, have recorded i in my Local Record with the above stated Registered Number, and on the basis thereof I HERE- BY GRANT A PERMIT to Regan & Denny, Inc. Quaker Rd. ,Glens Falls, N.Y. (Name) (Address) the Undertaker to hold temporarily and Inter the body (Enlertaker or person having charge of corpse) (Inter, remove, herwise dispose of (stat how)) Dated 5/-/7 - 197e (Signed) . / Local Registra 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 t(% ;;;(-- was p``//" 19 (Interment or iiiomat_ (Name of Cemetery, ' Section Lot No. Grave No. (Signed)ned) A-41 (Person in Charge) 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 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. 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. r Registered No. 1 1c Town, Village Dist. No. S-la- ? County Warren or City Town of Queensbury If city, give street address) Name of deceased Jessie E. Bennett Veteran No (If veteran, give name of War) Female Single, married,widowed, Widowed Sex or divorced (write the word) Date of Death March 7 19..7 Age 87 Years Months Days Birthplace New York State Cause of Death Sudden death syndrome associated with coronary atherosclerosis Certificate was signed by S. Richard Spitzer M.D. Address 90 South St. ,Glens Falls, N.Y. Place of Burial (or Removal) Town_-.of--_Queens-bur-y_,___NY (If body is to be temporarily held, fill in space later) Cemetery Pine_-_View__Race___Vault Date of Burial _Marc_b. .9 19.2.8. (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 Regan & Denny-,Inc. Quaker Rd.,Glens Falls, N.Y. (Name) (Address) the Undertaker to hold temporarily and Remove the body (Unlertaker or person having charge of corpse) ( (Inter, remove, ocerwise disp e (state how)) Dated 3- 8- 19?J_ (Signed) - Local Re ' rar This Permit is sufficient for the Removal (and Interment or Cremation) of a body to any p 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 was /7r2/7 19 77 (Interment or Cremation) (Name of Cemetery, orium etr:)--.--_,_. Section ��-ie Lot No. Grave No. /7 00 (Signed) \i,,, .�� (Person in Charge) Address /4 j 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. • Form VS-67 (rev. 11/65) NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records FUNERAL DIRECTOR or UNDERTAKER'S REQUEST TO DISINTER BODY In completing this form, please typewrite, hand-print or write legibly all entries in permanent black or blue black ink. Signatures should be legible. This is a permanent record. When data cannot be obtained, write "UNKNOWN" in applicable spaces. I hereby request permission to disinter the dead body of: Name of Deceased Male Age(yrs.) Qr7 i~s i..0 E, 3ennett 4� i Female 8t Place of Death (indicate whether city, village or town) Date of Death Cause of Death Tn of teen bury, �� `.L� ' ,' :1 yen Death Syndrome Cemetery now interred Location (city, town or county) Is body to be transported by common carrier? Pine View Rec., Vau?t. 'fin of Queensbury,N,Y, COYes X No State fully the final disposition to be made of body. Interment Nettle of place or cemetery for final disposition Date of final disposition Seeiye °:cemetery, Tn of Queenebury,N,Y. 4 18/78 `Firm Name Reg.No. Address Regan & Denny, Inc, 02883 Quaker Rd, ,Glens Falls, N. Y. 'Signature of Funeral Director o ndert ker Reg. No. Date 0 794 4/17/78 • INSTRUCTIONS TO FUNERAL DIRECTOR OR UNDERTAKER: 1. See Section 13.1 (formerly Chapter XIII, subdivision 4) of the Sanitary Code, relating to the transportation of dead bodies by common carriers, as printed on the back of the Transit Label. 2. The data required concerning the decedent may be obtained from the local register or cemetery record. INSTRUCTIONS TO LOCAL REGISTRAR: 1. For bodies to be transported by common carrier, fill out Transit Permit. 2. For bodies not to be transported by common carrier, fill out ordinary Official Burial (or Removal) Permit. 3. In each case write the word "DISINTERMENT" on the Permit. 4. This form should be filed and carefully preserved in your office.