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Oliver, Richard F.
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Richard F Oliver Male Date of Death Age If Veteran of U.S.Armed Forces, 05/05/2020 70 Years War or Dates II.— Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address Albany Medical Center Hospital W 'p Mannerof Death ©Natural Cause Accident Homicide Suicide Undetermined Pending U Circumstances Investigation W MedicalCertifier Name Title Mary Maskell-Amirault NP Address 43 New Scotland Ave,Albany,New York 12208 Death Certificate Filed District Number Register Number City,Town or Village Albany 0101 1016 ❑Burial Date Cemetery,Crematory or Facility Name 05/06/2020 Pine View Crematorium Entombment Address Cremation Queensbury Town,New York Donation 0 Removal Date Place Removed and/or and/or Held ~ Hold Address t� O d Date Point of cn ❑Transportation p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition orto Whom F- Remains are Shipped,If Other than Above Address W a` Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/06/2020 Registrar of Vital Statistics Danie(Ce S Gilrespie(ECectronicaffy Signed) (signature/ District Number 0101 Place Albany, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of osition Dis W p 7'20 Place of Disposition 2 (address) W NIM (section) (11 number) /gravenumber) 0 Name of Sexton or Perso Ch a of Pre s z (please print) W Signature Title -� DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 013731 Receipt Human remains of ? `� delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#