Farrington,Paul Joseph NEW YORKSTATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
Paul Joseph Farrington Male
Date of Death Age �Ifteran of U.S.Armed Forces,
04/09/2020 51 Yearsr or Dates
Place of Death Hospital,Institution or
W City,Town or Village Glens Falls I Street Address 2 Roger Street,Glens Falls, New York 12801
p Manner of Death MI Natural Cause
W Accident Homicide Suicide Undetermined Pending U Circumstances Investigation
WD Medical Certifier Name Title
Timothy Murphy Coroner
Address
52 HAVILAND AVE,Glens Falls, New York 12801
Death Certificate Filed District Number Register Number
City,Town or Village Glens Falls 5601 170
Burial Date Cemetery,Crematory or Facility Name
04/10/2020 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
ZO ❑Removal Date Place Removed
and/or and/or Held
~ Hold Address
N
O
(L Date Point of
U) Transportation
by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped,If Other than Above
'dr Address
W
IL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/10/2020 Registrar of Vital Statistics WWpAett/lndrewCuit&(EkctronkalySoned�
(signature)
District Number 5601 Place Glens Falls, New York
I certify that the remains of the decedent identified above were dispose¢�f in accordance with this permit on:
H � �
Z Date of Disposition ( �pyy Place of Disposition �j�L �� ok-.
g (add ss)
W
(se 'on) // (( (lot number) (grave number)
0 Name of Sexton or Person in Charge of Pr mises �/7 S 1� {2�/ /�Ii1e
Z � (please pr)nt/
W Signature Title
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) 013523 �
Receipt I
Human remains of ', delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#