Raggi, Roberta fl
B n.,"+b 1 I -1 ,t,f, f
309-O8 V I c QIurnmrnurn altl� of itlaoou I u t4 � R-309.08 I C)t;P.);', 'i 0003460
ttj((jyy��BC t ;'i! ;41s'f.IGrl 00 vY� ,�y ... ...fk'JG:
No
No -� 4.f'.
DISPOSITION, REMOVAL AND
OFFICIAL ssSPOertTION, s r19,s A TRANSPORTATION PERMIT TRANSPORTATION PERMIT
(beast under the provisions of Chep7er 719,Section 45,General Laws,Ter.Ed.,as emended)
This permit cen be signed only by the agent of the Board of Health foe In towns where there Is no Board of Health by the town clerk)of the city or
town In which the des occurred AFTER the FILING and acceptance of a satisfactory certificate of death, or typed in 'tent black This section to be returned immediately to the Issuing City/Town,properly endorsed
it
City/Town.,, dS
ft Date .. N. .... �.(.... ./ to
)1.
( ficc Lc5 ing permitl
A satisfactory deat erti Cate hay been filed for
ikal.
City/Town of AS Mass,
i +++..r
' / pcn ode .dent
who died on it Name of Decedent .... .,.... •• ••• •
s
}}}555���, 97,..5US WsVeteran11date of Rh / I/ If a U.S, War Veteran, specify what war,organization,etc,
bowho resided at
d o tutt / Lit tuse____
A-()--rL t/' CW: etiffittiieltr-t-H' &1/45/7e ENDORSEMENT
and who died of 4(tit--0
. � "1 iti 0,,,e t eetetiSO4m— y (To be filled in by cemetery or crematory Official)
give immediate cause
Permission is hereby given for(check all appropriate boxes): I hereby certify that the body accompanying this permit was
I 1 Removal from: ,,,, disposed of in accordance with its terms
1name and a ss of ooginal d sposfnon f
4�j �► at
I I Disposition at: cy
.,4............. .. ( ((hams of cemetery or crematory) (Ci[V r"iov,°ni
a,,,,..,i,5
me and adddressofceme'v or cra r/l r r/ T a j o
I I Transportation to: ✓�., .,./,.. 1 /l/w/ (((//// pp��� on
ne and address of immediate dent/ Lion of remains
Pe fission is hereby given (� Final Disposition
1 ( '
.. NV tA..'
`�'S et f r 05 RIR,"/-/� Certified by
(�7 ��,�'1 � � f, '� ittift--•
/ 1 (Signature of Superintendent,cemetery or crematory)
address of F ciliils...41
t�
!f there is no officer in charge,funeral director must sign and return this stuh.
Signature of Board of Health Agent,or,in towns where there is no of Health,of Town Clerk)
RAGG I Lot No. 2 6 D
Address `f O Lyons C Qu r-fr $(2042..eNA: N4 12304, Section No.
Owner Peter & Rosemary Raggi Plot Erie
Date 5/27/2014
Approx. 33 Superficial ft. @
Location Bounded on the North by Vacant, East by Steele
West by Vacant and South by Calby
Corner Posts
Remarks 760-402-7060
Deed No. (and changes) 3849
Payment Record Paid in full on 5/27/2014 ( $700.00)
Record of Interments
VACANIT
RD eituew, (5 )Act)Aoli-t)16
zA
lAl
LX
s , Q s C ) r4
E.
ti SrEELE
Form No. 01
14 A Al fi Raggi, Roberta . .-
Age:
Cause:
Lot Owner: peter & Rosemary Raggi
Lot # 26D Erie
Grave # 1
Case # Concrete
Died:
Interred: 5/28/2014
Undertaker: