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Yole, James Steven
NEW YORKSTATE DEPARTMENT OF HEALTH BUriat - Transit Permit Bureau of Vital Records Name First Middle Last Sex James Steven Yole Male Date of Death Age If Veteran of U.S.Armed Forces, 05/14/2020 69 Years War or Dates H Place of Death Hospital,Institution or WCity,Town or Village Hartford Town Street Address 1604 Baldwin Corners Road,Hartford Town,New York 12827 a Manner of Death ©Natural Cause �Accident �Homicide �Suicide ❑Undetermined �Pending Circumstances Investigation W Medical Certifier Name Title Anthony Petracca MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Hartford 5759 10 Burial Date Cemetery,Crematory or Facility Name 05/15/2020 Pine View Crematorium Entombment Address Cremation Queensbury Town,New York ❑Donation ZO ❑Removal Date Place Removed and/or and/or Held O �- Hold Address N a Date Point of (Q ❑Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address IFI 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 or to Whom Remains are Shipped,If Other than Above Address Q W C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/15/2020 Registrar of Vital Statistics Denise Petteys(Electronically Signer (signature) District Number 5759 Place Hartford, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: w Date of Disposition 611b 120 Place of Disposition (address) W N (section) (lot number) (grave number) � j Name of Sexton or Person in Ch a of Premise Z Adseprintl W Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 013S2 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#—