Loading...
Murray, Michael Matthew NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Michael Matthew Murray Male Date of Death Age If Veteran of U.S.Armed Forces, 08/07/2021 87 Years War or Dates 1956-1957 Place of Death Hospital,Institution or Z City,Town or Village Malta Town Street Address 2 Primrose Circle,Malta Town,New York 12020 p Manner of Death ©Natural Cause ElAccident ❑Homicide Suicide ❑Undetermined ❑Pending Circumstances Investigation W Medical Certifier Name Title 0 Jean Hanson PA Address 325 Main Street,Hudson Falls Village,New York 12839 Death Certificate Filed District Number Register Number City,Town or Village Malta 4560 37 ▪Burial Date Cemetery,Crematory or Facility Name 08/10/2021 Pine View Crematorium Entombment Address lCremation Queensbury Town,New York ❑Donation ❑Removal Date Place Removed and/or and/or Held ~ Hold Address W 0 d Date Point of N Li Transportation Shipment p by Common Carrier Destination El 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 1— Remains are Shipped,If Other than Above 5 Address LC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/10/2021 Registrar of Vital Statistics Jennifer Marie Motmes(E(ectronicafy Signed) (signature) District Number 4560 Place Malta, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition g l!(IN Place of Disposition 4� (L Q---- 11.11 (address) W NCC (section) t_ (lot number/ (grave number) S Name of Sexton or Person in Charge of P miser G / lease print) W ilirrA lab Signature /✓/"`/ Title rK DOH-1555(07/18)p 1 of 2 4 Public Health Law Sec. 4145(2b) r Receipt Human remains of delivered on , 20 <' + Pine View Cemetery Representing the funeral home named n byriaLp4trmit Official Funeral Directors Reg.or License#