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HomeMy WebLinkAbout2661 . . . . . • . . ~ . _ . . . ~F~. . . . ~Ja.~%r'~ C _ _ _ ^~r~...~r~w~._.~.+~ CONNECTtCUT STATE DFPI~RTMENT OF H ALTH ~ ~ ~ Publie H~~ItI~ Stati~tie• Seetioe-- • t1..~t•.i. Gsweetteat U.S.A. - ' ~ ~ I.ept Fee: i1.00 ~ Cert?ficate of D~eath " ~P7 l. h~~i w Du?Tw: IaI State ot Cowseetkut ~/St'M. Rt11KMq N D~ea~ws t~1 iua CO?1T1. , riOrA~ ~~A (~i0Y11ff ~f~ ~MA ~a~ R!~{dM!'~ ~M{I~! t+ew Haven NeW ~iaven NeW Havon I Weat Haven . c~~, ~ e«~,~? u.~~~.t 'a N) ~me o( U~a a+q1 0~ Inalitution le Stnre N~~wl~? 1~~+ Q No ~ Ilf ~st in • Awv~ul ot institotiaw ~Iw StreK Ha IlI w~a~ ~ir~ k:~lfMl lt Ye~, w~nN Clt~ w ' K Me~tio~ ) ~ " St.• RQ~~IAf'1 :'103p~t&1 16? Thamas sti. - Meet Xave~ i. N~MS W 1~'intT (1~1iddle) ' ~sc~q ,US GRA`tE ~:•u . ~ 0 ~•,a ~rso• K~n.~nu " " L~s , .:4 ",,,-jlr ~j - - - - ~lIEOI~A~CENj [ M ~t~ PFF5oNAl. AIVD STATISTICAL PARTICULARS ( ' '~;Y !L C~i•~s er DsArN fEatp•~ ~.q+N_~Mr 1q (~1~~1 ~~~el~ &cs i. lGcs • ~ ' • ~l } t. M~aaiw N~rs~ M~:ucu .r ixnars~ • ~ . f~ill9 ~ ,~ill 1iA ~ O r~~t 1. Dt•iN wAf Cl?~ISp B~t ~tiP•[fN rv~oo~rse q~o 0 lwruv~ts Q~vs~~~l ~ exsrr T. ` ~ . ~ osnsw f j. NAtqCD. WIOOKO Ot DIFp11L7l~ Olt~ ~IAIOLN NAlIt M u r`~ j.~ ~i ~ • ~f N'fft 0~ HVYANO ~ ~ . ~ . y~~~~'V *tinnie Ramev f : • - ~ DAt~ M (Mo~ti) IDa1) ` y - AuR ie i~) ~ T~ . _ ,i' Feb. 19 ~9~i~3 c..~~,~,.. ~ _ ij u •~?Ka `T,~I~.'+A trX - .t 1~. ,?n or D~tm Acs fin .s~.~ H~~ 1~ i ~ re+~s i( nndcr 1 rear if unde? t d~~ ~loh e~we ~ - O~~ r• i~t Mrtbda~) MoatL~ Dy~s Hw~s b1i~u, f~). tUUn~ ~ el~ .M•~b• Dus ro fe) , 1/20/1897 ?2 ~ - ~ ~.w~ p~,~~'jt I~~~/~a.,tt , il. 61srin.r?ts (Ciqr or wwn) (State or [wei~a eountr~) 7/~ df'~ Q SCr~IS/s Y~~ _ Greece 1'wer 11 OTNl~ SICNIIit'ANi CONMTN~Ne GNi~1~U71N0 W~s » Dc~tN ~V~ NOT RcuTSO to Txe 'I~r~x~~ Duen Aemrstt CONM[pN OI~N IM ~'ART I(~~. ~'tRtOR1~p? 1!• (s) Uiu~b Otcu?wipt~ IGirc kind of sork done drrie[ ~eott p~ Yr ~N~ O s~ workiat lile even it relired) ' ltc,tir,:d Nestaurunt Owner 21. 9UttltY I~tlillANt TO C~NNTI~M~ ~RMtp IN IT~Y n. ;'~i f?1 lKOUSratr oe Bus~ytss f~l H~iw ~l ~M?~tiee . I f~1 D~t~ rtr(~ f,,: ~ 3 Declcar Hest. 1~ f~) Wws Duusts w Vsrc~?t+! Ye~ or No ~0 ; 1~1 It Te~, `ire ~~r !i. t~l Aee~es~ Svrens HetiKas ~?1 TIN~ M iM~ear I N~w N~wtA. Dr~. ~'Mt - ~ Uait or St+~P . Q ? ? - - ~*1t~20I21, Gramel i s IH IMiu~r Occv~un ~d1 Pua e? iwauar (a~., iw ~bst A~.u. ~ - 1~. N~~r_ ~ } fC~tr or to.n) lstate or lbrei~~ eoratr~) wA1b ~t N~t Wl{b /s?~ J~tf~?Ir. «n~l. yte~ N!/.. i ~1 ~ I~s. s~K~~.~..« ~ t~reoce w..? w~.4 p ~i: 111 x~rosn j- £1 t h e r i n e ? c,r.. 7orN, o. Lou?nuK ca,Krr sr.ts .s: ~ M ~ i~. NAM~ - ~ IC~ty or tm?s) (S~ate or forei~s eountr~l ~!:r. e~.*u.+.,?cs ~ i•raece ~r~ ~sc.ui NoK ~N,~.,r o«~,..s.. lF.wt~r w~lrr~ ~J fwjrry h Pr?t / - i+~ : 15. 1K?O~MANY~ NAMt or p~rt N~J iltw lt.j 1` ,-rs. Minnie Gramelis it. I IfEREBY CER?IFY. ee.e t.a~.a u» a.~..~a t~. Feb . j 9 ~1 ~ r , s~. : _ D.~~ 2? 1, 69 7a 1t . ~.o »ss/~_ . ~~69 ; c..kt~:i~ .r c..~.~-~rpreen u.~ i wt w. ~K....a ~~...~/~~C~/~ ri.~ rle~w~ ~i v,en 'CQnn. ~.e a~s ~...w a~... «t.~.ra a. 3~. NAlls OI'B :It 8007 !r E71~ALIlfa Liesew aansba E ~t Q•~• ~w. ! James- ~.,_coiiaie`-~.~-;- I 135? :1~~~~~~~ • ~ ~ ~ hael zuba y . _ 21. l~NAriut, N Llcu~ao -~t Ltsr F ca~6 ~ i • ~ ;i Cele ~ tano I - . • ~ ; ~ ~~a~;;= 2 E'~ t. - w Haven, Conn. ~,~„„l~Jy~,~ . 7~~-''~i~d~?, ~ r T H 1 C A T&~ , O N R } ~ F b 0 - ~ B* } + ' FvRR Y { - % ~ _ , ~ _ . . _ ~ ~ , r . ~.f.~„'~--`-- ...._.._..._..,j_~:,~,..,~,~:__ 1 1 eertiF~ tLal~t?i? j~;a,. t t iatorm tien oo tb~ de~t6 reeori u r~eorded i~ t6i~ ~e~. i , ' r:~?~~~ - _ , ' Attes . . . . . Rest~trar •t Vitd St~tt~tie. . n.~.a ............Fsbruary..20, .1969 I+~ .$~...~~~t . . . . ........re... .f . . . . . MOT COOD WITHOUT 3EAL OF CERTIFYING OFFtC1AL t v.s. ~ ac I . - - - _ . . _ __._._.,_,..,,,,,,r...~, , ~ . : ~ j7 S r ~ . ~ ~ ~ : r- ~i ~ ~o ,~~~o ; t c) r=~ fV - D i ~ v .~rnZ i (7 Z, ~ ~ f7 ~ ~G ~ • o~ ~ ~ ~Zn _ j~ ~ -i ~ ~ C N • • ~ ~ ~ N`-~~~j 0 R r~~p v, D o 800~( PACE ~UJO ~ ' ~ - . { u ~ _ _ ~ -s^'w - - r-~~a ~ ~a. ~=s : . - :ci7 - ~Y£ _ ~ m~`~~-."}' _ . .