Austin, Gary NEW YORK STATE DEPARTMENT OF HEALTH 7
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Gary Austin Male
Date of Death Age If Veteran of U.S. Armed Forces,
04 / 22 / 2016 64 War or Dates N/A
}- Place of Death Hospital, Institution or
WCity, Town or Village Greenfield Center Street Address 176 Sand Hill Road
a Manner of Death®Natural Cause �Accident Homicide �Suicide Undetermined �Pending
Circumstances Investigation
W Medical Certifier Name Title
a John DelMonte MD
Address
3 Care Ln Suite 300, Saratoga Springs, NY 12866
Death Certificate Filed District Number Register Number
City, Town or Village Greenfield Center
>' 0Burial Date Cemetery or Crematory Pine View Crematory
04 / 25 / 2016
.ili.iiii QEntombment Address
Cremation Queensbury, NY
Date Place Removed
Z Removal and/or Held
2 and/or Address
Hold
lo Date Point of
Q Transportation Shipment
a by Common Destination
lig Carrier
Q Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
in Name of Funeral Home Compassionate Funeral Care, Inc 00364
niii Address
Ii 402 Maple Ave. , Saratoga Springs, NY 12866
iiiiiii Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2 Address
it
ILI
Permission is hereby granted to dispose of the human remain described abo as indicated.
iiigi
Date Issued LI 1Q5 apI(o Registrar of Vital Statistics U e
(s nature)
District Number y9 7 Place Greenfield Center , New York
iiiii
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z � Ij
i Date of Disposition el/Z7/11, Place of Disposition , Vfi—1 +�i""m..
12 (address)
0
CC (section) (lot number (grave number)
Name of Sexton or Person in Charge f Premises AS 0
11,Z ase print) .
ill
Signature Title (4M1��t
(over)
DOH-1555 (02/2004)