Hunt, Craig f 71'5
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Craig A. - Hunt Male
Date of Death Age If Veteran of U.S. Armed Forces,
October 20, 2015 62 War or Dates
Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
0,' Manner of Death 0 Natural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined ❑ Pending
tilCircumstances Investigation
Medical Certifier Name Title
�' Michael Fuller MD
Address
100 Park St. Glens Falls, NEw York 12801
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls 5 6 01 1 5
❑Burial Date Cemetery or Crematory
October 22, 2015
ID Entombment Pine View Crematory
Address
®Cremation Quaker Road Queensbury,NY 12804
Date Place Removed
❑ Removal and/or Held
and/or Address
Hold
Date Point of
Transportation Shipment
` p
by Common Destination
Carrier
Date Cemetery Address
El Disinterment
Date Cemetery Address
❑ Reinterment
Permit Issued to Registration Number
Name of Funeral Home M.B. Kilmer Funeral Home-SGF 01078
Address
136 Main Street, South Glens Falls NY 12803
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
X
iii
tt, Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 1 0-22-1 5 Registrar of Vital Statistics n,A,_; LA,. vv
(signature)
District Number 5601 Place City of Glens Falls, NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition 10/22/2015 Place of Disposition Quaker Road Queensbury,NY 12804
(address)
t (section) /9 (lot number) (grave number)
Nal- Name of Sexton or Person in Cha ge of Premises C hr Supdt-
(please print)
Signature
4 ( lL
Title
(over)
DOH-1555 (02/2004)