Norton, James NEW YORK STATE DEPARTMENT OF HEALTH F 1741
Vital Records Section Burial - Transit Permit
7 Middle Last Name First Sex
AA JAMES W. NORTON MALE
E Date of Death Age If Veteran of U.S.Armed Forces,
2/18/2018 38 War or Dates
Place of Death Hospital, Institution
City ,Town or Village City of Albany or Street Address 28 MAPLE RIDGE AVE. _
la Manner of Death Natural Undetermined Pendin
1 ❑ Cause ❑ Accident ID Homicide ❑ Suicide ❑ ® g
Circumstances Investigation
Medical Certifier Name Title
PAUL L. MARRA CORONER
Address
11
112 STATE STREET, ALBANY, NY
ty Death Certificate Filed District Number Register Number
City,Town or Village City of Albany 101 00417
Date Cemetery or Crematory
❑ Burial 2/21/2018 PINE VIEW CREMATORY
❑ Entombment Address
® Cremation QUEENSBURY, NY
1 Date Place Removed
Z Removal and/or Held
0, ❑ and/or Address
1F Hold
U)
Date Point of
IL Transportation Shipment
CO ❑ By Common Destination
CI Carrier
El Disinterment Date Cemetery Address
❑ Date Cemetery Address
Reinterment
Permit Issued To Registration Number
Name of Funeral Home COMPASSIONATE FUNERAL CARE INC. 00364
Address
4 402 MAPLE AVE. SARATOGA SP. NY 12866
I _ Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
=L'
Address
W
AV Permission is hereby granted to dispose of the human remains describe oveg in ' d.
Date 2/21/2018 Registrar of Vital Statistics
Issued (signature)
District Number 101 Place City of Albany, NY
A
I certify that tt'e remains of the decedent identified above were disposed of in accordance with`� this permit on:
Z Date of Disposition Zi iiIi ' Place of Disposition ' v Vs„. I vr`_
w (address)
2
w'
c (section) d (lot number) (grave number)
0
0
Z' Name of Sexton or Person in Charge of Premises ar: SA--41
w (please print)
`�
Signature Lam( Title itE 9/_
(over)
DOH-1555 (02/2004)