Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Harrington, Nancy Ann
• —1Lf NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Nancy Ann Harrington Female Date of Death Age If Veteran of U.S.Armed Forces, 09/04/2021 79 Years War or Dates 1_ Place of Death Hospital,Institution or WCity,Town or Village Milton Town Street Address Gateway House of Peace • Manner of Death ©Natural Cause 0 Accident ❑Homicide 0 Suicide ❑Undetermined Pending Circumstances Investigation W Medical Certifier Name Title O Paul Filion MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Ballston Spa 4561 47 Burial Date Cemetery,Crematory or Facility Name 09/10/2021 Pine View Crematorium Entombment Address X❑Cremation Queensbury Town,New York ▪Donation Removal Date Place Removed and/or and/or Held H Hold Address 0 n. Date Point of Cl) Li Transportation Shipment p by Common Carrier Destination 0 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 i— Remains are Shipped,If Other than Above Address trs W a Permission is hereby granted to dispose of the human remains described above as indicated. 'Date Issued 09/06/2021 Registrar of Vital Statistics Brenda7fowe(Electronically Signed) (signature) District Number 4561 Place Ballston Spa, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 1- Z Date of Disposition q 1/0111 Place of Disposition FAA,V 2 (address) W CC CC (section) d (lot number) (grave number) c Name of Sexton or Person in Ch of Premises (n^` Vr� ✓'V'�''"`f't1' l lease print/ uJ Signature Title iw kTD DOH-1555(07/18)p I.of 2 2)/LQt&n,� '' 7 !,-)1 5126 Public Health Law Sec. 4145(2b) Receipt NR N C4 01-Kr Or' 1 Human remains of delivered on , 20 ..* t Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#—