Frinton, Joseph NEW YORK STATE DEPARTMENT OF HEALTH- S
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joseph J. Frinton Male
Date of Death Age If Veteran of U.S. Armed Forces,
,-, 11/30/2018 76 War or Dates 1960-1962
, Place of Death Hospital, InstitutiA or
City, Town or Village Glens Falls Street Address Calms Falls Hospital
Manner of Death® Natural Cause ❑Accident ❑Homicide ❑Suicide ri❑ Undetermined El❑Pending
Circumstances Investigation
-t' Medical Certifier Name Title
Amy Johnson, RPAC
Address
Evergreen Health Ctr.,Corinth, NY 12822
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls 5601 5-Z,0
Date Cemetery or Crematory
❑BUflal 11/30/2018 Pine View Crematory
El Entombment Address
®Cremation Queensbury, NY
; Date Place Removed
-❑Removal and/or Held
and/or
Address
Hold
Date Point of
r ❑Transportation Shipment
; by Common Destination
Carrier
❑Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Brewer Funeral Home, Inc. 00211
Address
24 Church St.,Lake Luzerne, NY 12846
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 humeri remains described ove as ind' ated
Date Issued 11/30/2018 Registrar of Vital Statistics _,-,4:2�� /2A-f?
_= (signature)
District Number-r h0/ Place City of Glens Falls
I certify that the remains of the decedent identified above ere disposed of in accordance with this permit on:
Date of Disposition I113($$ Place of Disposition Z40..., ,:,,fort. .„
(address)
(section)
lot umber (grave number)
Name of Sexton or Person in Charg of Premises
;I I ...) e..4-41
(pl ase print)
Signature a Title
(over)
DOH-1555 (02/2004)