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Lee, William P. NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex William P.Lee Male Date of Death Age If Veteran of U.S.Armed Forces, 05/15/2020 56 Years War or Dates _ Place of Death Tsp ital,Institution or WCity,Town or Village Sarato a Springs eet Address Saratoga Hospital p Manner of Death ®Natural Cause Accident Homicide Suicide Undetermined Pending W Circumstances Investigation U W Medical Certifier Name Title 0 Qiong Wang MD Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City,Town or Village Saratoga Springs 4501 285 Burial Date Cemetery,Crematory or Facility Name 05/19/2020 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ZO Removal Date Place Removed and/or and/or Held H CO) Hold Address O d Date Point of N Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom F— Remains are Shipped,If Other than Above M Address W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/18/2020 Registrar of Vital Statistics John 2'aufEranck(ECectronicady Signed) (signature) District Number 4501 Place Saratoga Springs, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Date of Disposition Za Place of Disposition dr�— LU (address) W N fY (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises 111 Z (ple a print) / W Signature Title 4 DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) ' 49 ? Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on buri4l permit Official Funeral Directors Reg.or License#