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Liimatainen, Alan 0°p3 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Alan Liimatainen Male Date of Death Age If Veteran of U.S.Armed Forces, 12/17/2020 61 Years War or Dates H Place of Death Hospital,Institution or W City,Town or Village Hudson Falls Village Street Address 318 Main Street, Hudson Falls Village, New York 12839 W Manner of Death © Natural Cause 0 Accident Homicide El Suicide El Undetermined ❑Pending 0 Circumstances Investigation W Medical Certifier Name Title CI Thomas Portuese MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Hudson Falls Village 5726 41 11 Burial Date Cemetery,Crematory or Facility Name 12/26/2020 Pine View Crematory 11 Entombment Address X❑Cremation Queensbury Town,New York ❑Donation Z Date Place Removed Q El Removal and/or and/or Held H Hold Address U 0 a. Date Point of Cl) �Transportation CI Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom - Remains are Shipped,If Other than Above "g Address CIC a` Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/24/2020 Registrar of Vital Statistics Cynthia ABarcfin(cCectronicallySigned) (signature) District Number 5726 Place Hudson Falls Village, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ZW 4 Date of Disposition I / iZl Place of Disposition g,tt._ 7:-1-4"--- 2 (address) W N X (section) (lot number/ (grave number) O (4.1` L ►ntJt 0 Name of Sexton or Person in Charge of Premi (ple Z print) W Signature Title (kook DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 014367 Receipt Human remains of + � ' delivered on A , 20--� Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# !' . •`