Baillargeon, Caleb Y
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PLNE Y'E'W CEMET>rRY AND J% � ���
QUAR n
ROo, CMATORIU QIlEEN RE M
SHVRY, K'eW YOR}C(518) 745.4476 (518) 745.4g71 128()4
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PUte View Cemelery and Crsmrt
21 ulcer Road,Owetisixry,New York, 12804
Cemetery Ofte:(518)745.4476,Cterrtabrki rt:(518)7464477
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The utdersbrod woo to and a4Mho lm Pkre View QW*twkan,In a000rdw=VM and a*jM b toe Redea and RepWatiorw to
CIA msoe the rdnreir>s ak
(iwso WAM)� (apT�)
rMwdied on 7 'l��: � d�►a� Sri L.fZ �o
dF
at
{Pteoej flkkkegs?
terse a addt�saa o€Hasse[twtnp ratarirs or rranrs or parson aIgo ioctslnp uerrgor. -
- ��IS.Ql2r .�• /.�i�L R 2rs-�v� ��
(ems) (Address) e14412n., Sr. L�/G{�i��aG iP, Ny
ReletlorretdpbthedeoeMad /:Z-4- rY-ZFX--
IlmneofftwM tlm 1 1 �'-t� ,lQ- �� a .
t represent that tithe beat of oaf[awrr'l%l ft dacaesad(has)ar s aoanelaer,dalbrMalora wW adrer 6apery OF a I I I d
device in hts or her body- (Ckb**
t arMiy prat 1!rare iti poaarand a anspe br the asneoon bf fire rand m w db dMiosttiretlso o ft n of the
psrrelsd ronrekre.thtsrgrpersonal;PolMabrfshaireNhrsbaaaaamowdaranl►be�deNoyed.aMagreebproMct,deFerd and
1Mr Pilla A *—Im- m Y!'ll cm-lo EqA,ernrmift f ..r-
bjrIconorarcvrnreasoterrriraaremaaararsaki,a I!, asureetad,w OM cfekaaordenrwrrisassar *v*
grotrraesR wNesorpsuonrara.
>,0, Itoo
a
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SWW on nwa dot«
otapooMm of Cromftd Reersins
i hereby dkW Pkre Vim Crone k n oo dispose of the crenralsd rerrmi o as bin I-
Md b /�. ��AQi1c_ GtJC
oarererrarr0errrerae-Pt fir•Ct,,,ve—L �ie—'A /6o�,p 2
eprAreri oom ofanrard tsnrekre is regrreeoed,dradc hers v
.,ff4my�=auras
Pokies, Rubs and Rep igtions
1. P �m is ioaated on the grounds of Pine View Canxfty.The
+�n °P�es MondaY through Fr W from 7:OOam to 3:30pm prior teteahone
arranoerromm�c
-----r ■w+ia:zs�mt we i#gpB"Spiy
n8; y ror Y aw nWons. ,
2. A "Aut wketivn for Cremation"si0ned by the nearest nwd of kin is necessary stating
that
d an the Power and au8�writy to arrange for the aernadon of the remains
a...__dWMW of wsonri--Yrs. v, ��:flAi QF rr��:y,AtM,w,oef the .�' r1flG�e4�ir^n�
harm�ss Pfie ViewCemetery and Crematorium MP A,d 1d and save*
PI
the be remainsandobrclsposlion +reason of cOnnWW with
such dalms are,or are not of said riemeirw asdirecled.whether
addition to a regular beuiat per mu�000nxww h fra vua erd,'this a�orh ation in
the terru�inee
3. Alt remains must be in a casket or a ahemate cortwr poets ad oorKa
must be of a comma !-No iners
* or c florMkW wwfg be accepted.
+4. Cardiac Wanakers,Wbfttm or otherbefty
operated devices must be removed
before any remain wik be acoegftd.
5. Cremations B wN be mnph tad vet three 8 days( Hours)of
of the
be MIOW vie Par w a�Author to rm Fo .The a�ernsd wiu
harx ft the u.SS &Mala�days Ofae�on to the i8 aai home
for this service. made.'Themwid be a$30.00 dwW
6. Cremation,AdninFstmtion Casts and Record
Adult �p Fees:
Chkhm (age 13 months to 12 33Y5.00
irk (Sdgtm n to 12 manths) $125.00
Overfime CramptkWft 11AA&.&.#;.—,k ♦I tw ww
��i11['7HV�� a'-�-+=•aa.:�asf i$",f��5
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