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Liimatainen, Alan (2)
0003 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 6' 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 0 Manner of Death © Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending UJ 0 Circumstances Investigation WMedical 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 ❑Burial Date Cemetery,Crematory or Facility Name 12/26/2020 Pine View Crematory ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation Z Date Place Removed 0 ❑Removal and/or and/or Held F Hold Address N , 0 a Date Point of Cl) ❑Transportation p by Common Shipment Carrier Destinatio9 Date Cemetery Address ❑Disinterment Date Cemetery Address ❑Reinterment 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 1- Remains are Shipped,If Other than Above 2 Address CC W 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 ABardn(ECectronicallySigned) (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: �,W Date of Disposition it('Zi Place of Disposition ��,� 77,_ 2 (address) W N CC (section) pot number/ (grave number) O L �,4�t 0 Name of Sexton or Person in Charge of Premi `� Z (pleras print/ ` t!J Signature Title 6 �( DOH-1555(07/18)p 1 of 2 014367 Public Health Law Sec. 4145(2b) Receipt ` n l.sa 'R Human remains of ti i ) �i} ' delivered on , 20 • j 1 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# i 1