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Kennedy Sr, Edward Joseph 3rs NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Edward Joseph Kennedy Sr. Male Date of Death Age If Veteran of U.S.Armed Forces, 04/15/2021 82 Years War or Dates 1995 ZPlace of Death Hospital,Institution or City,Town or Village Saratoga Springs Street Address Saratoga Hospital pManner of Death © Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending uJ Circumstances Investigation LLI 0 Medical Certifier Name Title Bert Pyle MD Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City,Town or Village Saratoga Springs 4501 251 ❑Burial Date Cemetery,Crematory or Facility Name 04/17/2021 Pine View Crematory ❑Entombment Address 1 Cremation Queensbury Town,New York ❑Donation g ❑Removal Date Place Removed F= and/or and/or Held N Hold Address O d 1-1 Date Point of (o ❑Transportation El Common Shipment Carrier Destination Date Cemetery Address El Disinterment ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom F— Remains are Shipped,If Other than Above 2 Address CC uJ O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/16/2021 Registrar of Vital Statistics John Paul'Eranck(ECectronicaCCySigned) (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: I— J W Date of Disposition L/-/7 2o,A( Place of Disposition `A,, t.)4 � S C/`Z',ii 4j 2 (address) W CC N (section/ (lot number) (grave number) CName of Sexton or Person in Cha e of Premise �Gllc�,� LA) CI Z Y (please print) uJ Signature / r Title aJ� DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 14 7 2 3 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# .fi