Loading...
Coley, Joseph 7 NEW YORK STATE DEPARTMENT OF HEALTH A*,. y..Vital Records Section Burial - Transit Permit Name First Middle Last Sex Gw�ik. ' Joseph James Coley Male Date of Death Age If Veteran of U.S. Armed Forces, , 07/30/2018 78 Years War or Dates 1957-1965 Place of Death Hospital, Institution or E City, Town or Village Granville Town Street Address The Orchard Nursing And Rehabilitation Centre Manner of Death©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Ta Circumstances Investigation Medical Certifier Name Title ra Jennifer Hayes MD Address '' 10421 State Route 40,Granville Town,New York 12832 Death Certificate Filed District Number Register Number City, Town or Village Granville 5756 30 ❑Burial Date Cemetery or Crematory r 07/31/2018 Pine View Crematory m ❑Entombment Address ®Cremation Queensbury, New York Date Place Removed Z❑Removal and/or Held and/or Address Hold itO Date Point of ❑Transportation Shipment by Common Destination Carrier ik Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number q.,,, Name of Funeral Home Wilcox&Regan 01821 Address Avg11 Algonkin St,Ticonderoga,New York 12883 Name of Funeral Firm Making Disposition or to Whom SRemains are Shipped, If Other than Above Address 77 Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/31/2018 Registrar of Vital Statistics jenny Linda Martet(e(ECectronicalTySigned) (signature) Districtvs Place Number 4.4 5756 Granville, New York 1-= I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 2 Date of Disposition g J3 II Place of Disposition 1'tAL Cry Z (address) (section) (lot nuf�per) (grave number) 1 Name of Sexton or Person in Charge of Premises G lot'f — _)ref __ (please pM%$ Signature Title C mN(al . (over) DOH-1555 (02/2004)