Baccari, Angelo NEW YORK STATE DEPARTMENT OF HEALTH
OFFICIAL BURIAL (OR REMOVAL) PERMIT
(GBF* 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.
Registered No. / 6 7
".( 3 Warren Town, Village Cityof Glens Falls
Dist. No. - County or City
If city, give street address)
Name of deceased Angelo P. BaCCari Veteran No
(If veteran,give name of War)
Single, married,widowed,
Sex Male or divorced (write the word) Widowed Date of Death Feb. aQ 192 u_._
Age 86 Years Months Days Birthplace Italy
Cause of Death Metastatic Carcinoma
Certificate was signed by Denis N. Lusignan M.D.
Address 90 South St. ,Glens Falls, N.Y.
Place of Burial (or Removal) Town of Queensbury, N.Y.
(If body is to be temporarily heldfill ins ce later)
Cemetery °Pine View "Cemetery Date of Burial Feb. 22 19 'sue
(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 Undertake to hold temporarily and Inter the body
(Unlertaker or per n ng ha ge of corps (Inter, remove, or otherw' e dispose of (state how))
Dated 19 ._ (Signed) i imi
This Permit is sufficient for the Removal (and Interment or Cremation) if = •rt y to a , part • the State (subject to local
cemetery or other regulations),unless removal is by common carrier, in which ca fflie Transit Permit S 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,� i -19 7/
(Interment or 04.4n.00,f)
(Name of Cemetery, G,r.gnaakart
Section Lot No. / Grave No.
(Signed)
( erson in Charge)
Address 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) DAY
with the Registrar of District in which cemetery is locate .
SEXTONS, FUNERAL DIRECTORS and UNDE TAKERS violating the law relative to the return of perm'
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.