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Plumley, CraigNEWYORK STATE DEPARTMENT OF HEALTH z03 B l T 'tP Bureau of Vital Records U1 a - rand ermlt Name First Middle Last Sex Craig H. Plumley Male Date of Death Age If Veteran of U.S. Armed Forces, 10/15/2019 54 Years War or Dates IF- Place of Death Hospital, Institution or Z LIU'p City, Town or Village Chester Town Warren Street Address 923 State Route 28N, Chester Town Warren, New York 12817 Manner of Death Natural Cause Accident Homicide Suicide Undetermined Pending U Circumstances Investigation Uj Medical Certifier Name Title C Terry Comeau Coroner Address 1400 St Route 9, Lake George Town, New York 12845 Death Certificate Filed District Number Register Number City, Town or Village Chestertown 5652 17 Burial Date Cemetery, Crematory or Facility Name Entombment 10/21/2019 Pine View Crematory Address K❑ Cremation Queensbury Town, New York ❑ Donation zRemoval Date Place Removed and/or and/or Held l- to Hold Address O IL ❑ Transportation Date Point of N 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 s I— Remains are Shipped, If Other than Above Address R W IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/18/2019 Registrar of Vital Statistics Minty Conway (EYectronicalTy S6,ne4 (signature) District Number 5652 Place Chestertown, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Z Date of Disposition Place of Disposition JDM 0— V C,e-0— m LU (address) W w(section) lotnumber) (gravenumber) 4 Name of Sexton or Person i a e of Premises G�✓ti ma- vl' Z W (please print) Signature Title DO H-1555 (07/18) p 1 of 2 ' Public Health Law Sec. 4145(2b) 013008 Receipt Human remains of t .f delivered on , 20 T Pine View Cemetery Representing the funeral'home named on burial permit Official Funeral Directors Reg. or License #