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Murray, Patrick James ii_p , , .. 4 76-) NEW YORK STATE DEPARTMENT OF HEALTH . ..-._. Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Patrick James Murray Male Date of Death Age If Veteran of U.S.Armed Forces, 09/23/2022 26 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Bolton Town Street Address 1492 East Schroon River Road,Bolton Town,New York 12814 p Manner of Death 0 Natural Cause © cident Homicide ❑Suicide ❑Undetermined Pending W Circumstances Investigation s Medical Certifier Name Title Lynn Kep PA Address 1340 State Route 9,Lake George Town,New York 12845 Death Certificate Filed Town Of Bolton District Number Register Number C' ,Town or Villa5e 0 5650 7 Burial Date Cemetery,Crematory or Facility Name O9/26/2022 Pine View Crematory Entombment Address Cremation Queensbury,New York Donation Removal Date Place Removed and/or and/or Held = Hold Address n a Date Point of Transportation Shipment by Common Carrier Destination Date Cemetery Address aDisinterment IDReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbkry,New York 12804 Name of Funeral Firm Making Disposition or to Whom F. Remains are Shipped,If Other than Above S Address CC W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/2612022 Registrar of Vital Statistics l (thartmicaj,Sliach9 (signature) District Number 5650 Place Town Of Bolton I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I- W Date of Disposition 9-Z 7-Zaz 7.- Place of Disposition Pi N-e--if,-24J G t°'ernw-kezi ni (address)/ W ID lsedbn/ (lot number/ (grave number) 8 Name of Sexton or Pers n Ch a of Premises t"'h n C.WI 4..c., .1. 2 (please��print) y�p� W Signature Title G'le✓t;4,7a r D�P-�X1� DOH-1555(08)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 I , . - Pine View Cemetery Representing the funeral home named on burialpermit Official Funeral Directors Reg.or License# it._ .,. It Sip Li 4. .,. ,NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Last Sex Patrick James Murray Male Date of Death Age If Veteran of U.S.A Forces, 07/16/2022 69 Years War or Data- - F. Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death E1 Natural Cause cidttt n Homicide Suicide Undetermined ❑Pending Ili W Circumstances Investigation W Medical Certifier Name Title G Marvin Davidowitz 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 367 Burial Date Cemetery,Crematory or Facility Name 1011.66° 07/18/2022 Pine View Crematory Entombment Address ▪Cremation Queensbury Town,New York ▪Donation O n Removal Date Place Removed and/or and/or Held H Hold Address N 0 n. Date Point of Cl)❑Transportation Shipment jr) by Common Carrier Destination Date Cemetery Address DisintermentEI Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom — Remains are Shipped,If Other than Above 2 Address OC W 0. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/18/2022 Registrar of Vital Statistics Megan Nolin(Electronically 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: IH Z Date of Disposition 1 I IQ lit Place of Disposition Tt nlyi. 2 (address) W Cl) (section) g+ , (lot number) _�.4n ,jt (grave number) Cr (section) `] C Name of Sexton or Person in Charge of Pre ' s �`i (p1 a print) /� W ri Signature Title ltoo� DOH-1555(07/18)p 1 of 2 i .-- v 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# -