Harrington, John William NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
John William Harrington Male
Date of Death Age If Veteran of U.S.Armed Forces,
03/03/2021 88 Years Waror Dates 1951-1954
Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc
p Manner of Death ❑X Natural Cause Ei Accident El Homicide Suicide ❑Undetermined EI Pending
W Circumstances Investigation
W Medical Certifier Name Title
0 Rick Teetz MD
Address
131 Lawrence St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 180
Burial Date Cemetery,Crematory or Facility Name
03/05/2021 Pine View Crematory
Entombment Address
X❑Cremation Queensbury Town,New York
Donation
ZZ ❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
Q. 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 Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
I— Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 03/05/2021 Registrar of Vital Statistics Join Pau19ranckgYectronica(Signed)
(signature)
District Number 4501 Place Saratoga Springs, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W _ AIL l 0f
Date of Disposition � $�Z Place of Disposition h
2 (address)
W
Ir (section) / (lot number) (grave number)
it
Name of Sexton or Person in Charge of Premi es A t y'"`"y
(plea!e print)
Z
W Signature Title [WA Q
DOH-1555(07/18)p t of 2
- -
Public Health Law Sec. 4145(2b) 014 315
Receipt
Human remains of ,, r ( delivered on , 20
Pine View Cemetery Representing the funeral home named On burial permit
Official Funeral Directors Reg.or License#