Hubert, Wiliam Post s 7?
NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
William Post Hubert Male
Date of Death Age If Veteran of U.S.Armed Forces,
07/13/2021 74 Years War or Dates Vietnam
t`— Place of Death Hospital,Institution or
W City,Town or Village Glens Falls Street Address 625 Glen Street,Glens Falls,New York 12801
IL
• Manner of Death El Natural Cause El Accident Homicide ElSuicide ED Undetermined El Pending
Circumstances Investigation
LIJ Medical Certifier Name Title
0 Aimee Mcmaster Nurse Practitioner,Acute Care
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed District Number Register Number
City,Town or Village Glens Falls 5601 288
❑Burial Date Cemetery,Crematory or Facility Name
07/15/2021 Pine View Crematory
0 Entombment Address
0 Cremation Queensbury Town,New York
Donation
ElRemoval Date Place Removed
and/or and/or Held
N Hold Address
0
Ct. Date Point of
toLi Transportation
p by Common Shipment
Carrier Destination
ElDisinterment Date Cemetery Address
t
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped,If Other than Above
S Address
rit
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 07/14/2021 Registrar of Vital Statistics Wp6ertAndiew Curtis(EkctronicallySigned)
(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:
Z
W Date of Disposition �S ti� Place of Dispositions a.►
2 (address)
W
CC (section) (lot number) (grave number)
SName of Sexton or Person in Charge of P ises L.
(pi se print) �i
W Signature Title airfi64RAI
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) -' 14,9 4 5
Receipt
Human remains of delivered on , 20 '
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
1