Springer, Joseph NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle SPRINGER GER MALESe
JOSEPH
Date of Death Age If Veteran of U.S.Armed Forces,
FEB. 2, 1993 76 War or Dates 1942-45
Place of Death Hospital, Institution or
w City,Town or Village Village of Ballston Spa Street Address Maplewood Manor
G Manner of Death
Natural
� ® ral Cause � Accident �Homicide � Suicide � Undetermined � Pendin
Circumstances Investigation
ii Medical Certifier Name Title
G L. Gelman MD..: .:
Address
.. 128 Milton .Ave , ..Ballston Spa, N Y
Death Certificate Filed District Number Register Number
City,Town or Village Village of Ballston Spa 4520 8
Date Cemetery or Crematory
❑Burial Feb. 2, 1993 Pine View Crematory
ElCremation Address
Queensbury, N.Y.
z Date Place Removed
O 0 Removal and/or Held
-. and/or Hold :::.:..
Address
cn
a. Date Point of
n 0 Transportation by Shipment
c3 Common Carrier ........... . ..............- ,:...: ......
Destination
Disinterment Date Cemetery Address
Reinterment Date CemeteryAddress
Permit Issued to Registration Number
Miii Name of Funeral Firm William J. Burke & Sons Funeral Home 00264
Ha Address
iim 628 Broadway, Saratoga Springs, N.Y. 12866
Name of Funeral Firm Making Disposition or to Whom
g Remains are Shipped, If Other than Above
�i A ii
ddress
G
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued Feb. 2, 1993 Registrar of Vital Statistics Q.lta-j 2 s�
(signature)
District Number 4520 Place Village of Ballston Spa
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition i 3�3 Place of Disposition I /�/Ak/ C Pe1/lt/4 it
2. (address)
w
CC (section) (lot number) (grave number)
tr>
0 Charge /L'�/7/D /.4/9 T7 u,4 p>: Name of Sexton r Person i of Premises ^� �---
Z< (please print) i�/4�/�/e�� //
w'' Signature ✓J'� Title
DOH-1555 (10/89) p. 1 of 2 VS-61