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Liimatainen, Alan v©O3 NEW YORKSTATE 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 F Place of Death Hospital,Institution or Z City,Town or Village Hudson Falls Village Street Address 318 Main Street, Hudson Falls Village, New York 12839 WW Manner of Death Undetermined Pending © Natural Cause Accident Homicide Suicide Circumstances Investigation W Medical Certifier Name Title O 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 ElBurial Date Cemetery,Crematory or Facility Name 12/26/2020 Pine View Crematory Entombment Address ElCremation Queensbury Town,New York Donation Z Date Place Removed O Removal and/or and/or Held I."' Hold Address N O a Date Point of Cl) ❑Transportation p by 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 2 Address CC ui 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 ABardin(ECectronicaltySigned) (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:gtit,_W Date of Disposition i/y l Zi Place of Disposition _ 2 (address) W (section) /lot number/ (grave number) 0 L +4,Ut a Name of Sexton or Person in Charge of Premi f W /pleas pr/ntl �` Signature Title L ir DOH-1555(07/18)p 1 of 2 ..1 f Public Health Law Sec. 4145(2b) 0 1 4 3 6 7 Receipt \-")Di , Human remains of \ ' , , ',.1 ,, i C'\\ . delivered on ' , 20'- 1 . , y -{ i i i , i Pine View Cemetery Representing the funeral home named ion burial permit Official Funeral Directors Reg.or License# . t