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Frye Jr., Drexel 5y2 NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Drexel Satterfield Frye Jr. Male Date of Death Age If Veteran of U.S. Armed Forces, May 14, 2018 62 War or Dates t Place of Death Hospital, Institution or ili City, Town or Village Argyle Street Address 19 Liddle Lane W Manner of Death X❑ Natural Cause ElI I Accident ❑ Homicide Suicide n Undetermined ri❑ Pending Circumstances Investigation W- Medical Certifier Name Title CI David Cunningham, Dr. Address 3 Irongate Glens Falls, NY 12801 Death Certificate Filed District Number r.156 Register Number City, Town or Village Argyle J I y ❑Burial Date Cemetery or Crematory May 16, 2018 Pine View Crematory ❑Entombment Address ©Cremation Quaker Road Queensbury,NY 12804 Date Place Removed z ❑ Removal and/or Held and/or Address Hold 55 Date Point of a 1-1 I I Transportation , Shipment 0 by Common Destination Ei Carrier Date Cemetery Address n Disinterment Date Cemetery Address El Reinterment Permit Issued to Registration Number Name of Funeral Home M. B. Kilmer Funeral Home- FE 01079 Address 82 Broadway, Fort Edward NY 12828 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped, If Other than Above m Address IX w Q. Permission is hereby granted to dispose of the human re ains described above as indicated. Date Issued Si 151 is Registrar of Vital Statistics let- k-,u„ (signature) District Number 5750 Place Oat/1< / k,Ili I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: �W Date of Disposition 05/16/2018 Place of Disposition Quaker Road Queensbury,NY 12804 2 (address) LU Ce (section) /�/(lot number) (grave number) 0' Name of Sexton or Person in Charge o Premises L <<. ( ease print) tit Signature Title (7? w, 1Uf2—, (over) DOH-1555 (02/2004)