Linton, Kenneth NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
0 Name First Middle Last Sex
Kenneth Richard Linton Male
Date of Death Age If Veteran of U.S. Armed Forces,
June 25,2015 89 War or Dates 1944-1956
'' Place of Death Hospital, Institution or
. City,Town or Village Queensbury
Manner of Death
Medical Certifier
Street Address 89 Haviland Road
Natural Cause ri Accident n Homicide n Suicide EUndetermined n Pending
Circumstances Investigation
Name Title
William Tedesco,MD
; Address
Glens Falls,NY
Death Certificate Filed District Number Rigister Number
G/%
City, Town or Village Queensbury, NY 5657 _
®Burial Date Cemetery or Crematory
❑Entombment July 1,2015 Pine View Cemetery
Address
❑Cremation Quaker Road, Queensbury,NY 12804
Date Place Removed
z ri Removal and/or Held
G and/or Address
,I— Hold
N
0 Date Point of
N Ei Transportation Shipment
a by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Vf Permit Issued to Registration Number
Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596
,,, Address
;, 407 Bay Road,Queensbury, NY 12804
,, Name of Funeral Firm Making Disposition or to Whom
1 Remains are Shipped, If Other than Above
Address
Permission is h reby gr nted to dispose of the huma r ains described tbvie as indicated.
Date Issued ( - registrar of Vital Statistics ems_ E? /1-
/s., (signature)
District NumberSZsS ►') Place O `-`- i-N. CrD l ...e-e—g-NS 3
I— I certify that the remains of the decedent identified above were disposed of in accordan e wi h this permit on:
Z
uiDate of Disposition 7/1 /1 5 Place of Disposition Pine View Cemetery, Oueensbury, NY
2 (address)
11.1
UU)) Seneca 1 3B 1
C (section)Connie L. Goe(i ermber) (grave number)
Z Name of Se),,,, or Person in Charge of Premises
,vj, (please print)
W Signature /?,OLt_¢ " Q Title Cemetery Superintendent
(over)
DOH-1555(02/2004)