McGinty, Thomas K NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Thomas K. McGinty Male
Date of Death Age If Veteran of U.S.Armed Forces,
03/01/2022 69 Years War or Dates 1970-1972
1_, Place of Death Hospital,Institution or
Z City,Town or Village Stony Creek Town Street Address 4 States Road,Stony Creek Town,New York 12878
W
p Manner of Death IINatural Cause Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
W Medical Certifier Name Title
CI Paul Bachman MD
Address
9 Carey Rd,Queensbury Town,New York 12804
Death Certificate Filed Town Of Stony Creek District Number Register Number
City,Town or Village 5658 3
Burial Date Cemetery,Crematory or Facility Name
03/05/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
H Hold Address
N
0
a Date Point of
Cl)OTransportation
p by Common Shipment
Carrier Destination
O
Disinterment
Date Cemetery Address
Ei
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Brewer Funeral Home Inc 00211
Address
24 Church Street PO Box 500,Lake Luzerne,New York 12846
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
5 Address
CC
a. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 03/04/2022 Registrar of Vital Statistics Susan I Harrington(Electronically Signed)
(signature)
District Number 5658 Place Town Of Stony Creek
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on::/
~ �(LW Date of Disposition 3 i� �Z2 Place of Disposition �4Z�-
2 (address)
W
NCC (section) Jlotnumber/ (grave number)
11-
0 Name of Sexton or Person in Charge of P ises ii v >�"'�l
Z (l lease print) �,�,,y
W Signature Title l Y
DOH-1555(07/18)p 1 of 2
1 J � rr
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named qn burrai'permit
Official Funeral Directors Reg.or License#