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Wilson, MarkNEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Mark S. Wilson Male Date of Death Age If Veteran of U.S. Armed Forces, n9/94/gnl 62 ears y War or Dates Place of Death Hospital, Institution or 44'1yvTown or)66M Ballston Street Address 12 Gartner Drive Manner of Death QNatural Cause Accident HomicideE] Suicide Ej Undetermined Pending Circumstances Investigation U1 Medical Certifier Name Title Rnhprt;a M*Iler MD Address 16 Crimson Oak Ct, Schenectady, NY 12309 Death Certificate Filed District Number Register Number AATown Or*30= Ballston 4550 17 El Burial Date Cemetery or Crematory ©Entombment Entombent 09/27/2019 Pineview Cemetery Address ❑Cremation Queensbury, New York ..... Date Place Removed Removal I I and/or Held and/or Address Hold Date Point of ) W Transportation I Shipment by Common Destination ..... Carrier ❑ Disinterment Date Cemetery Address Reintermeant Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Townley & Wheeler Funeral Home 01719 Address 21 Midline Road, Ballston Lake, NY 12019 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address L.0 Permission is hereby granted to dispose of the human re ins described above indicate Date Issued 09/26/2019 Registrar of Vital Statistics (signature) ..... District Number 4550 Place Ballston I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition Place of Disposition (address) (section) (lot number) (grave number) Name of Sexton or Person in Charge of Premises (please print) Signature Title (over) DOH-1555 (02/2004) PUBLIC HEALTH LAW § 4145. Deaths; burial and removal permits; disposition of remains. 1. No person in charge of any premises on which interments, cremations and other disposition of the body of a deceased person are made shall inter or permit the interment or other disposition of any body unless it is accompanied by a burial, cremation or transit permit, as provided in this article. 2. The funeral director or undertaker shall deliver the burial permit to the person in charge of the place of burial or other disposition, before interring or otherwise disposing of the body; or shall attach the removal or transit permit to the box containing the body, when shipped by any transportation company, which permit shall accompany the remains to its destination, where if within this state, it shall be delivered to the person in charge of the place of burial or other disposition. 3. The person in charge of the place of burial or other disposition shall endorse upon the permit, the date of interment, or cremation or other disposition over his signature, and shall return all permits so endorsed to the registrar of his district within seven days after the date of interment, cremation or other disposition. 4. When burying or otherwise disposing of the body of a deceased person in a cemetery or burial place having no person in charge, the funeral director or undertaker shall (a) sign the burial or removal permit, giving the date of the burial; (b) write across the face of the permit the words 'No person in charge;' and (c) file the burial or removal permit within three days with the registrar of the district in which the cemetery is located. 5. The person in charge of the place of burial, cremation, or other disposition shall keep a record of all bodies interred or otherwise disposed of on the premises under his charge, in each case stating the name of each deceased person, place of death, date of burial or disposal, and name and address of the funeral director or undertaker, which record shall at all times be open to official inspection. DOH-1555 (02/2004) TOWNLEY It WHEELER Ft 1NFR AL HOME Deceased: Mark S. Wilson Address: 12 Gartner Drive Ballston Lake, NY 12019 Next -of -kin: Rosemaria Wilson 12 Gartner Drive Ballston Lake, NY 12019 Phone: 518-527-8351 Marital Status: Married Age: 62 Date of Birth: November 7, 1956 Place of Birth: Troy NY Date of Death: September 24, 2019 Place of Death: Ballston Lake, NY Service Date: September 27, 2019 Service Time: 11:00 am Service Place: Calvary Episcopal Church Disposition: Entombment Officiant: Father Gabriel Morrow Dateline: Ballston Lake, NY Mark S. Wilson, age 62, died on Tuesday, September 24, 2019, comfortably at his home with his loving wife by his side. Mark was born on October 7, 1956 in Troy, NY to the late Harold and Shirley (Williamson) Wilson. .\lark attended Burnt -Hills Ballston Lake High School and following his graduation earned his associate's degree at Schenectady Community College. dark was a hard worker and shared his talents with many different companies. He served as a store manager for Home Fabric Mills in Glenville for over 20 years, and later worked at various other home stores, such as Lowes, Home Depot, and Builders Square. Mark loved having a good time and being around his family. He was an avid bowler and enjoyed his time at the local alleys. Mark was a former communicant of Our Lady of Grace Church and most recently attended Calvary Episcopal Church. Mark is sur-nved by his loving wife of 27 years, Rosemaria Wilson; his siblings, Dennis (Michele) Wilson and Debbie Qeff) Daniels; and his adoring nieces and nephews, Chris Wilson, Matt (Alex) Wilson, Elizabeth Wilson, Amanda Daniels and 7ach Daniels. A Requiem .glass will be celebrated by Father Gabnel '_Morrow on Friday September 27, 2019 at 11:00am at Calvary Episcopal Church, 85 Lake Hill Road Ballston Lake, New York. Entombment will be in Pineview Cemetery, Queensbury, New York. In lieu of flowers, memorial contributions may be made to Calvary Episcopal Church, 85 Lake Hill Road Ballston Lake, New York. With confidence, the family has placed their trust in the loving care of the Townley & Wheeler Funeral Home, 21 Midline Road, Ballston Lake, and they encourage you to view and leave messages on Mark's Book of Memories at l own] eyWheelerFfl.coin 21 MIDLINE ROAD, BALLSTON LAKE, NEW YORK 12019 — -,tin I'll T' A A I K 71 rNn An I r r I rn r,I �nhI Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on 01.0344 , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License #