McNeill, James NEW YORK STATE DEPARTMENT OF HEALTH
a
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
James Dennis McNeill Male
Date of Death Age If Veteran of U.S. Armed Forces,
July 10, 2015 43 War or Dates
Place of Death Hospital, Institution or
City, Town or Village Argyle Street Address 1557 Hemlock Lane
Manner of Death 0 Natural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined r—i❑ Pending
Circumstances Investigation
Medical Certifier Name Title
w
. Darci Ann Gaiotti-Grubbs, M.D Dr.
G.r
.r.; Address
102 Park Street Glens Falls, NY 12801
Death Certificate Filed District Number Register Number
k City, Town or Village Argyle S 7 S o 3 p
❑Burial Date Cemetery or Crematory
U` July 20, 2015 Pine View Crematory
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❑Entombment Address
r ®Cremation Quaker Road Queensbury,NY 12804
� Date Place Removed
❑ Removal and/or Held
and/or Address
Hold
Date Point of
❑Transportation Shipment
by Common Destination
'� Carrier
❑ Disinterment Date Cemetery Address
='El Reinterment Date Cemetery Address
Permit Issued to Registration Number
"_' Name of Funeral Home M. B. Kilmer Funeral Home-Argyle 01077
; Address
123 Main St., Argyle NY 12809
Name of Funeral Firm Making Disposition or to Whom
H - . Remains are Shipped, If Other than Above
Y= Address
Permission is hereby granted to dispose of the human remains describedabove as indicated.
Date Issued I ( 31 15 Registrar of Vital Statistics � `1-rti t_1iJ,..K
(signature)
District Number s-7 S o Place C Agr./(i , {l,�
�7 I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 07/20/2015 Place of Disposition Quaker Road Queensbury,NY 12804
' (address)
= (section) (lot number) (grave number)
Name of Sexton or Pers n in Charg of Premises L , Jl,sof
�r (please
Signature Title
(over)
DOH-1555 (02/2004)