Hill Sr., Edward •.r.. ■Vnn a1riIG Ycrimn.iMG1I1 urr rIcim.iri
OFFICIAL BURIAL (OR REMOVAL) PERMIT
inr 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. P-31\.0
Dist. No. f601 County �d°larren o Town, City of Glens Falls
If city,'ivve street address)
Name of deceased Edward J. Hill,Sr.Sr. Veteran j�
(If veteran, give name of War)
Single, married,widowed,
Sex Male or divorced (write the word) Married Date of Death June 21 19t'-'
Age 47 Years Months Days Birthplace New York State
Cause of Death Cardiac Arrest
Certificate was signed by Richard P. Leach M.D.
Address 17 Pine St. ,Glens Falls, N.Y.
Place of Burial (or Removal) Town of Queensbury,N.Y.
(If body is to be temporarily held fill in space later)
Cemetery Pine View Cemetery Date of Burial June 23 19 7v
(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 ReLan & Denny,Inc. Quaker Rd.,Glens Falls, N.Y.
(Name) (Address)
the Undertaker to hold temporarily and Inter the body
(Unl aker or person having charge of corpse) (Inter, remove, or otherwise dispose of (state how))
Dated _` a-j 10 '._ (Signed) `C 7 •
cal Registrar
This rmit 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
)71-;(:
Date ."11-- was h — 19 71 -
(Interment or
(Name of Cemetery,
Section ,2 Lot No. /4� &Grave No.
(Signed)
(Person in Charge)
Address `e 1W
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.
RILL, Edward J Sr.
( (Y)
Age: 47
Cause: Cardiac Arrest
Lot Owner: Walter Welch
Lot # 1081, Sec. 22, Uncas Plot
Grave # 1
Case: Concrete
Died: 6/21/78
Interred 6/23/78
Undertaker: Regan & Denny
•
WELCH
Lot No. 1081
Address VanDusen Rd. , West Glens Fella, N.Y. Section No. 22
Owner Walter Welch Plot Uncas
Date December 31, 1968
100 Superficial ft. @$1.50 per sq. ft.
Location Bounded on North by Path, East by Path and let of Dutson, West by
Vacant, South by Path.
Corner Posts
Remarks
Deed No. (and changes) 1081
Payment Record Paid in full December 31, 1988
•
. a
'Form No. 01
Record of Interments
• C4,-01-1.8
Edward J. Hill Sr r (6/23/78) , (JOYC E L 1k� t i• t�• a a �►�' 1� •�-
Qoa
Walter E. Welch (7/23/73) -�4,11 7,mzfh )11 �/ C� 3c� a �� -�`,
tea i�8 31
I Florence Welch 13 '28-LA; - fin' 7
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