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Garvin,James Edward • NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex James Edward Garvin Male Date of Death Age If Veteran of U.S.Armed Forces, 02/02/2022 74 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death ©Natural Cause ❑Accident El HomicideEl Suicide ❑Undetermined ❑Pending Circumstances Investigation WMedical Certifier Name Title Asim Chaudry MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 75 ❑Burial Date Cemetery,Crematory or Facility Name 02/09/2022 Pine View Crematorium ❑Entombment Address Cremation Queensbury Town,New York ❑Donation Z Removal Date Place Removed 2 and/or and/or Held N Hold Address O 4. Date Point of b) ❑Transportation a by Common Shipment Carrier Destination Date Cemetery Address ❑Disinterment ❑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 l— Remains are Shipped,If Other than Above 2 Address W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/03/2022 Registrar of Vital Statistics Megan Noan(E1 ctronicallySigned) (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: Date of Disposition a to-2-y Place of Disposition i)[nt) V;ej Grbffirtr idY UJ ad ress) cc (section) (lot number) (grave number) 8 Name of Sexton or Pers n in Charge of Premises C-irtit�lr Uti ri S (please print) W Signature ,e4��� Title (IUl9«�o1 DOH-1555(07/18)p 1 of 2 1i r9 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on buxial permit Official Funeral Directors Reg.or License#