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Harrington, David Moses
LEINOBurialNEW YORKSTATE DEPARTMENT OF HEALTH - Transit Permit Bureau of Vital Records Name First Middle Last Sex David Moses Harrington Male Date of Death Age If Veteran of U.S.Armed Forces, 06/23/2022 71 Years War or Dates F Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death El Natural Cause Accident Homicide Suicide Undetermined Pending IJJCircumstances Investigation W Medical Certifier Name Title G William Cleaver MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 332 ©Burial Date Cemetery,Crematory or Facility Name 06/30/2022 Pine View Cemetery Entombment ' Address Cremation Queensbury Town,New York Donation Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 0. Date Point of (I)ETransportation CI by Common Shipment Carrier Destination 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 2 Address CC ILl O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/28/2022 Registrar of Vital Statistics Megan Wolin(E1 ctronicary Signed) /signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 1 ) a,�( I— Z Disposition •13,D Dispositionp7/ et c" eiXA IY 77 LU Date of Place of (1CG 1 r•� L� (address) U w 1--;Ri er /I A InCC (s• (lot number) (grave number) I- S Name of Sexton or Person in Charge of Premises A n n 7C ck - z (please print) l/ IU Signature / Air Title �C/ ?er 1 n 7�17 ) /,T .t DOH-1555 lo7/18)p 1 of 2 , Public Health Law Sec. 4145(2b) 012928 Receipt Human remains of delivered on , 20_ Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# HARRINGTON (iLFF NAME David Moses Harrington Age: 71 Lot Owner: David & Linda Harrington Lot# Erie 1 1 A Grave# 1 Case: Concrete Died: 6.23.22 Interred:6.3 0.2 2 Funeral Home: Carleton FH Cemetery: Pine View