Jones, Carrie 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.
Registered No. ._ S
Dist. No.
560 i County Warren Town, Village
or City City of Glens Falls
If city, give street address)
Name of deceased Carrie I. Jones Veteran No
(If veteran,give name of War)
Single, married,widowed,
Sex Female or divorced (write the word)Widowed Date of Death July 16 19_29_
Age 94 Years Months Days Birthplace Vermont
Cause of Death Cerebral vascular insufficiency
Certificate was signed by William N. St.John,_ M.D.
Address Glen St. ,Glens Falls, N,Y,
Place of Burial (or Removal) Town of Queensbury, N.Y.
(I body isto be temporari 1w1d, fill in space ly later) Jul 1
Cemetery �L• � � Date of Burial 3t 9 19_7 9
(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 In 4r the body
(Unlertaker per o aving charge of corpag), / r remo , o r e d'spo of (state how))
Dated �' 1917 (Signed) <
Lo Registrar
This Permit is sufficient for the Removal (and Interment or Cremation) of a body to y 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)(7A2-53)
ENDORSEMENT OF SEXTON OR PERSON IN
CHARGE OF PREMISES ON WHICH INTERMENTS
OR CREMATIONS ARE MADE
Date of TntPrmPnt was ,Tul y 19 1979
(Interment or Cremation)
St. Alphonsus
(Name of Cemetery, Crematorium, etc.)
Section Sp• A Lot No. Grave No.
(Signed) � 1
(Pe on in in Charge)
Address 35 Broad St. , Glens Falls, N.Y.
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.