McNaughton, James NEW YORK STATE DEPARTMENT OF HEALTH ' ff -
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
James Oscar McNaughton Male
Date of Death Age If Veteran of U.S.Armed Forces,
01/18/2018 84 Years War or Dates 1953-1955
Place of Death Hospital, Institution or
City, Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc
Manner of Death[Ai Natural Cause Accident El Homicide El Suicide Undetermined n Pending
Circumstances Investigation
Medical Certifier Name Title
Rick Teetz MD
Address
131 Lawrence St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City, Town or Village Saratoga Springs 4501 44
❑Burial Date Cemetery or Crematory
01/19/2018 Pine View Cremation
❑Entombment Address
®Cremation Queensbury Town, New York
Date Place Removed
Removal and/or Held
and/or Address
Hold
Date Point of
Q Transportation Shipment
by Common Destination
Carrier
El
Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Carleton Funeral Home Inc 00281
Address
68 Main Stpo Box 67,Hudson Falls,New York 12839
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/18/2018 Registrar of Vital Statistics John P Eranck(E!ectronually 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:
Date of Disposition //u)it Place of Disposition f;�J✓
(address)
(section) 4(lot numbert— (grave number)
Name of Sexton or Person in Charge of Pre9 ises L �fpl.�- ""4
° (please print)
Signature (i'" Title leepi pit,
(over)
DOH-1555 (02/2004)