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Wemmitt, John Ernest A 5i1 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex John Ernest Wemmitt Male Date of Death Age If Veteran of U.S.Armed Forces, . 06/17/2021 83 Years War or Dates 1956-1960, i_ Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital pManner of Death ©Natural Cause E Accident Homicide ❑Suicide ❑Undetermined ❑Pending UCircumstances Investigation G Medical Certifier Name Title Connie Goedert Coroner Address 1400 St Route 9,Lake George Town,New York 12845 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 254 ❑Burial Date Cemetery,Crematory or Facility Name 06/22/2021 Pine View Crematorium El Entombment Address ElCremation Queensbury Town,New York • ❑Donation Removal Date Place Removed OP and/or and/or Held ~ Hold Address CO 0 O.CD ❑Transportation Date Point of p by Common Shipment Carrier Destination IDDisinterment 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 H Remains are Shipped,If Other than Above 2 Address CC W C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/22/2021 Registrar of Vital Statistics gg6ertAndrew Curtis(E(ectronicaCCySigned) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I- Z Date of Disposition 41�31ZI Place of Disposition Fetit/i", 4,_ 2 (address) W Cl) IQ (section) Jr number) (grave number) SName of Sexton or Person in Charge of Premis Ai So4,01 Z (please int) W Signature �'�-- Title � iNNlnlf? DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 0 1. 4 0 Receipt Human remains of delivered on , 20 1 F Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#