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Murray Jr., Frank Joseph et 0 • a\(>6 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Frank Joseph Murray Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 03/17/2021 66 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Granville Village Street Address Granville Center for Rehabilitation and Nursing W Manner of Death ©Natural Cause 1=1 Accident ❑Homicide El Suicide El Undetermined Pending Circumstances Investigation WMedical Certifier Name Title Leonard Gelman MD Address 17 Madison St,Granville Village,New York 12832 Death Certificate Filed District Number Register Number City,Town or Village Granville Village 5725 17 ❑Burial Date Cemetery,Crematory or Facility Name 03/19/2021 Plne View Crematorium ElEntombment Address ElCremation Queensbury Town,New York ❑Donation 6 El Removal Date Place Removed and/or and/or Held F- Hold Address 0 Id. Date Point of t/) ❑Transportation p by Common Shipment Carrier Destination ID Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom F 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 03/19/2021 Registrar of Vital Statistics RichiardRp6erts(E(ectronica1Ty Signed) (signature) District Number 5725 Place Granville Village, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H � Z Date of Disposition 3; (1.,2,rj f/ Place of Disposition elk) (r—eivi 2 (addres W CC (section) (lot number) (grave number) 8 Name of Sexton or Person in Charge of Premises Tj/41/00,," k/ WZ !��7 (please print/ Signature � Title !'��t�'_�-+��f'' DOH-1555(07/18)pi of 2 0 Public Health Law Sec. 4145(2b) 1 4 6 5 E Receipt Human remains of delivered on , 20 . , Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#