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HomeMy WebLinkAbout0918 535443 1981 Jt!! 10 A:~i i~ 3S ~i~~c ekt cuN,~ta Sl.l l'CI[ ~WM' X11 A. i{(1(~~.R Pp1 i F.15 ~ LLEFK CiRCJ11 t 1(jit; _ , . . , , . ~ . ` • ' ~OCA~ I~EGISTRAR COPY ce~w~ w~ • ~~,n o~wOM ~ooeocooairaer NEW YORK 8TATE 535443 ~ ~ E ~ ~EPARTMENT OF HEALTH ' CERTIFICATE OF DEATH 57~Ti3lK/1~pif111CT t.NAYE flq LAST l.tEi ~ pA1EOf0EATN ' REC ~ E fEYKE ~TN Mt ~ 1fEM ~ HARiOLD ~T~ JISAPH .1~• _ ~ O ~2 ~ i RES If tlNOtl~ 1~EM i YNOE11/ W1Y • OECEOENt WIIN • YETEMN Oi Y. . MY[O i011CEi7 L iOCUI fEW11R1f ± rOMfM_ Ow*! M011M rMY~O YOMfM Wt tEw11 NO i~ES.i~EGi~t1NA110110ATES NYY~EiI . . - 5~ ; ; RIL;21 ~ 9 ~ ~ W~rl~ war Trro 6-22-22~+ ~ M COVNir Of QEATN M ~OCKTf ICNEqtONE AMO VEC1M • ~G N03PIiAl OR OTNE1~ x~3iffUflpN ~s w~ 1LL ~E ~s W w1~EN 8~' ~ ~ ~ Ili NEITNE1l WVE A0011E33! ~ M~3l~T CRONE) ~ ADYKS~ON OA~E ~ Suffolk Huntington ~ 504 Oakwood Road ~;$E ~ o ~ 'aoan.wT~N, ~ ~ ~ y~ ~ ? Ml~AOE Oi _ ~ ~N~ATKNf • ~ ~ ~ W• STAiE Oi 6WTH t0 CRREN Oi rIl1Y1 ~ tt. MM~7At fTAtYE KNECK ONE) ~t SYIWIVINfi SIOU6E 11F rMfE OIYE WVOEN NAYE) ~ O ICOYNiM IF NOT VSIU COUNilttt 9_ • wcvice uwww~o a p«~oowco p@W York II~$~A• ~~~oowsE?wwwTCO.Qavoecco Joan Crowley ~a wwCE wnuiE.~wCK Ow ~N ~5 ~,p ~s EdiGwtqN wpCw~EHqMESTOnwOECW~ht~EDpttr AYE R~CAM ~MDMN. IF rE5 G[ ONE ? ; EIEYEMTA11r ~ NpNtCIqQI COlLEOE ~ 3 OTMER If~EGFYI ~ O YEtIGN ~ Q 07NE11 VAN~SN : NIERiOIY!'J1N 014O~M11?EC1iY1 O t ! i ~ • ~ 1 • 1 2 ~ ~ 1 t ! • i White aoooooooa oo?o aooo7b o~E.~~~ ~o,~~a~ao~a a,o,~,: SpyTN AYEN~CAN 14 tM VSYw~OCq!?A1qN100M07EME11RE1WED1 ~N ~uNOOf WS~NESSORM~OYSTM eV~~~Own ~g~~VV~ 3 ndustr3al~ A?rts Te~ch~r ~igh School ion Avenue~Levittown, _ t tA S1ATE ~ t f~. COUMY ~ t ft tOCKITIIICMECR ONE ANO aIEp~11? ~ t)E 1i C~TI Op ~nllwOE. ~S pES~DE nCE ~ MI1NW GTI OR YKIAGE 4Yrt51 ~ rES ? usuu~s~~ 2 New York ; ~uffolk ~ n~~ ~tington ~ WHERE DECEOENT p vwuoE os - - - - - - - - - - - - - - + ~ s No. s~an rowu: s ~ _ _ ~ _ ~ ~ ~ ~ ~ ~ ~ ~ 1I~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ _ J ~ Y ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ ~ , lnfFD_ ~ 110 6TqEETIWOMYY~ENpi 1lES1pENCE (INQypE II~COOEI _ _ _ _ _ _ ~ Hunt ington ~ 504 Oa kvood Roa d - ~ _ 'ti ~ iqlsi YIOpLE lwyi tb IWST ~ YWpLE i ~ NwYE OF ; ~ ~~~Ep Harold J. Asaph Rose Miedr`~ch Yp1MER : 1 EA tM NAYE Oi MKOIIYAMi ~t~ YAK~NO ApO11ES5lWtlVOE 21~ COOEI r s. Joan Asaph 50~ Oakwood Road~ Huntington~ Nev Yor = 70A BUR1At, C11EYAilON. REMOYAI pl YpqiM OAV ~?ACE O~ 01lRU1L CREYATION. REYOVAL pp ~pC IOCATqM (Gir Oq TOIYM. SiATEI 1 b B OiNEfI pSl06~i1pN IS~ECiY1 OTNER pSWSliq/1 - ~ o Burial July28~;19 BII.S.National Cemete~y~ PinelaMrnlNew York ~ p 2tAMwYEAMOADOf~ESSOfNNERAL~IOYE ~ ~ . ~ ~7pA/qNNO : ; s~ _ ~ 9 4 New York Avenue, Huntington St n~ w Yo~ ~~I~O~~b7 ; I O t?A MAYE OF iYM[RAl OMEC1d1 ~ tl~. NAT OF i OMEtT TMT~ON NO ~ f Peter Connell ~ ' ` ~ s 3 ~ S fi . raw s~ctw?TUweoswEa~ruw ~ a?i¢ ~pwrw OAY =aA SURUIOANEVOVAL . r..~- N owr ruw . ~ ~ ~ : t ~ ~ ~ ~.~+~L~V ~ fREO ~ ~ ~ 1 , , • ~ ~ ~ ~ "-~4.~!!!~--~1~ ~ ~ ~ r ` : t'• 7G ~ ' . : f TO BE COMPLETED BY sE' D BYs~ ~ ~ CERTIFYING PHYSICIAN ONLY -~R,. CORON ~!(AM) NLY . A TO TME SESi Oi Yr RM(iWIEOQE OFAiM OpC{lqpEO AT TME w OM iNE ~51,4 OF TIOIIT TWE.OAtEANOKAtE~AMDOVET07?1ECAUSESS1AiE0 rMYY01W~ONOEATH Ej1~1 ?~~~Ep ~ 2 7 / M M1~ ~EAw AND RACE ANO DVE TO - S~ ?~s~~ ' -r ~ ~ ~ S~ONATYRE ~ ' + ( t ~ , ~v ~ . MEOIUI ~ ~FI[AYWEM W S~GNATUNE . ' ' . . ~ t~ 1tµTtE ~ ~ e TME PH~S~CWI ATTEMOE07~ OECEASEO C LAST EN AIrYE S?NONOUNCEOOEAD C NOUI~:- ~.f ' D OATE S~GNEO ~ YOM~N OMI 11EAA YO~M OAt ~'EM YONTM OA7 ~[Y~ YON1N d11 RM YOMiM M~ tEM W sROY. ~ ~ Tp ~ ~ ~ ~ ~ _ ON ~ ~ ~ A1 M~ ~ ~ ~ a,,~, , , . , . , . D MAYE OF ATTEMpM6 i OiMER TIY1N CERfi~R ~ E S~GMATYRE OF CdqNEN'S MYSICIAN. K OTNER TIU1M CERTIF~ER . 3:~ ? ..............................................~~-~------.._..........._...U.. ~ ~ 76 E AN E3S CEN7~FIER C E EpCAt E1cAY~NE0. EHE h1YSICWI. pRECTOAI ~ ~ , , ~~;-~N. tI. DE N WASCAUSEO M EMER ONLr ONE GUSE ~ER [IME FOR (A1101 AMDIt1 APPNOZ~MATE ~MTEMAt OEiMEENONSETANDOEATN ~ PARt 1 EOtA7E ~ CO~IOfI1011S. i ` AMT. Mrt~ Ci1rE ~ISE TO ouE ~swcoNS[ouENCC os ! 1r11~1~1E " ~ ~ CA~SE u~~ ~s~ ~ Si~irC TIE ovE 70. Ow wSACOwSEOUfwCE Os . Y~T~r : ~ C~fE U1i`~ W K~ ~ ' b IMiMO~MERS~GNKrCANiCONp~T1pNS~CONpiqNSCpNiIUNJ7WGT0 ?MAUTOPSV7 ~BKI~ESMEREfINpNpSCONS~OEi~EOM1 USfNEFE~1Rf0 ~ OEAiM WT NO7 REtAiED TOGUSE~i/11EM W?Mi I I/V ~rES ~p ~ pE1EpYlNINp TME CAUSE OF OEATHt TOCORONEM di ~~HS ~ ~ rEdCKE~twYWfR1 } ~ _ V O~~ ~ p rES : p Mo ~ res s p wo ~ ]QI~ SVECKr IF ACC~OENi NOw1GOE ~DS OATE Oi ~ ]OC NOUR OF ~00 OESCAISE NOM 1NJY11v OCCYRNED SUK~DE. YMOEIERwWE0. ~EM0~~6 INJURII t ~ IMVESi1611T10N i wOMiN W~ ~[Y~ ~ ~ ' iJ Fi 1 ~ ~ 1 1 t / ~ ~ ~ y 1 ! , ~OE INJUM Ai N0111['? ~~/t/KE Qi 1NJUpY ~qyE. ~~06 LOCAiION ~SipEET i Np_ C~r pl YRIAQE. iO1MM. COUNt~. S7ATE1 ~ f/1CTOR~.OFi1CE R06 . EiC ~ ~ ~~S rE5 MO ~ ~ ? ? ~ ' ~ I i i'~OD ~ 8~359 PbGE y18 ~ a= - v ~ _ ,