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McClure, Denis Joseph •s -. #"N NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Denis Joseph McClure Male Date of Death Age If Veteran of U.S.Armed Forces, 01/12/2020 87 Years War or Dates 19514952 +,. Place of Death Hospital,Institution or Z City,Town or Village Johnsburg Town Street Address Elderwood at North Creek Uj ,p Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation WMedical Certifier Name Title Michael Miles MD Address 112 Ski Bowl Rd,Johnsburg Town,New York 12853 Death Certificate Filed District Number Register Number City,Town or Village North Creek 5655 2 Burial Date Cemetery,Crematory or Facility Name 01/13/2020 Pine View Crematorium Entombment Address Cremation Queensbury Hamlet,New York Donation Z ❑Removal Date Place Removed 0 and/or and/or Held F Hold Address ❑Transportation Date Point p by Common Shipment Carrier Destination Disinterment Date Cemetery Address EjReirrterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Barton-Mcdermott Funeral Home Inc 00141 Address 9 Pine St,Chestertown,New York 12817 Name of Funeral Firm Making Disposition orto Whom } Remains are Shipped,If Other than Above Address M 1tJ' 9L Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/13/2020 Registrar of Vital Statistics 4(pthfeen C.Lorah(Efectranica!/ySigned) (signature/ District Number 5655 Place North Creek, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ~ Disposition p l.�r Z Date of Dis sition y �Zfl Place of Disposition , tiJ ' W (address/ tU a (section) (lotnumber) (grave number/ Name of Sexton or Person in Charge of Premises 4, ase print) W Signature Z7 Title DOH-1555(07/18)p 1 of 2 i Public Health Law Sec. 4145(2b) .` 13 2 t Receipt Human remains of , �' ? delivered on , 20 Pine View Cemetery Representing the'funeral home named on burial permit Official Funeral Directors Reg.or License# r �_ i