Swinton, Barry L (LF) 4/ 613
NEW YORKSTATE DEPARTMENT OF HEALTH _ � � Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Barry L.Swinton Male
Date of Death Age If Veteran of U.S.Armed Forces,
07/29/2022 67 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Glens Falls Street Address Glens Falls Hospital
,p Manner of Death 11NaturalCause Accident Homicide Suicide Undetermined ❑Pending
V J Circumstances Investigation
W Medical Certifier Name Title
C3 Scott Biasetti 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 401
Burial Date Cemetery,Crematory or Facility Name
08/03/2022 Pine View Crematory
Entombment Address
Cremation Queensbury'iown,New York
Donation
❑Removal Date Place Removed
and/or and/or Held
p
Hold Address
0
IL Date Point of
Cl) Transportation
El Common Shipment
Carrier Destination
ElDisinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander Baker Funeral Home 00037
Address
3809 Main St,Warrensburg,New York 12885
Name of Funeral Firm Making Disposition or to Whom
F Remains are Shipped,If Other than Above
Address
EC
W
O.
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/02/2022 Registrar of Vital Statistics Megan No(in(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:
Date of Disposition 913 r ZZ Place of Disposition � 'dn__
ILI
(address)
W
CC
(section) (lot number) (grave number)
SName of Sexton or Person in Charge of P i s + � �-- cisv440
Z (phiase print/
Signature Title
DOH-1555(07/18)p i of 2
p -t
Public Health Law Sec. 4145(2b)
Receipt
Human remains of t delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#