Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Prescott, Richard H
/g3 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Midd Last Sex Richard H Prescott Male Date of Death Age If Veteran of U.S.Armed Forces, 02/26/2022 88 Years War or Dates H Place of Death Hospital,Institution or WCity,Town or Village Lake Luzeme Town Street Address 121 E River Drive,Lake Luzeme Town,New York 12846 'p Manner of Death xiNatural Cause ElAccident El Homicide 1:1Suicide El Undetermined El Pending Circumstances Investigation W Medical Certifier Name Title Christopher Hoy . . MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Lake Luzeme 5656 5 ElBurial Date Cemetery,Crematory or Facility Name 02/28/2022 view Crematory ❑Entombment Address IDCremation Queensbury Town,New York ElDonation © �Removal Date Place Removed and/or and/or Held fN Hold Address 0 a Date Point of ❑Transportation by Common Shipment Carrier Destination 11 Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address CC W 0" Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/28/2022 Registrar of Vital Statistics Cynthia Sherwood(Electronically Signed) (signature) District Number 5656 Place Lake Luzeme, 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 31 1 I n Place of Disposition (...�, 2 (address) W CC V) (section) (lot number) , (grave number) gName of Sexton or Person in Charge of Pre 'ses ��'� ruil Iyl Z (plea e print) ti W Signature LJ� Title �"'FA,tbtltL DOH-1555(07/18)p 1 of 2 144 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#