Harrington, Joseph NEW YORK STATE DEPARTMENT OF HEALTH 1 # 1 l
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joseph Paul Harrington Male
Date of Death Age If Veteran of U.S. Armed Forces,
April 11, 2014 40 War or Dates
Place • :-ath Hospital, Institution or i i
'
City own r Village Argyle Street Address 1 1 Y\t _Vt R Rti Art o,/LE
Man - • Death❑ Natural Cause ❑ Accident ❑ Homicide ElSuicide ❑ Undetermined '� Pending
Circumstances Investigation
Medical Certifier Name Title
Max Grossman, M.D. Dr.
Address
65 Poultney Steet Whitehall, NY 12887
Death Certificate Filed District Number Register Number
` City, own Village Argyle 5 750 1,a
r,❑Bur Date Cemetery or Crematory
April 14, 2014 Pine View
. El Entombment Address
m ®Cremation Quaker Road Queensbury,NY 12804
Date Place Removed
❑ Removal and/or Held
anHoldd/or Address
Date Point of
❑Transportation Shipment
by Common Destination
a Carrier
Date Cemetery Address
❑ Disinterment
Date Cemetery Address
❑ Reinterment
Permit Issued to Registration Number
Name of Funeral Home M. B. Kilmer Funeral Home 01079
Address
82 Broadway, Fort Edward NY 12828
s 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 human remains described above as indicated.
Date Issued 4 I/cf)Loki Registrar of Vital Statistics ns/ MI`44A,,,,,
I (signature)
District Number -I 5u Place A'5',t
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
n Date of Disposition 04/14/2014 Place of Disposition Quaker Road Queensbury,NY 12804
(address)
,° (section) (lot number).,. (grave number)
0 S
Name of Sexton or Person i Charge of Premises dprill..tt- it+04
(please print)
''.. Signature pL-- Title ovo,vot-
(over)
DOH-1555(02/2004)