Saville, Paul H ( LF)
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Paul H.Saville Male
Date of Death Age If Veteran of U.S.Armed Forces,
11/13/2022 90 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Kingsbury Town Street Address 17 Green Barn Road,Kingsbury Town, New York 12839
p Manner of Death n Natural Cause Accident Homicide 0Suicide FlUndetermined Pending
W Circumstances Investigation
U
W Medical Certifier Name Title
Sean Campanie NP
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed Town Of Kingsbury District Number Register Number
City,Town or Village 5762 22
Burial Date Cemetery,Crematory or Facility Name
11/17/2022 Pine View Crematorium
Entombment Address
IIICremation Queensbury Town,New York
Donation
ZO Removal Date Place Removed
and/or and/or Held
H Hold Address
0
Date Point of
1Transportation Shipment
by Common
Carrier Destination
Date Cemetery Address
[11Disinterment
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
1— Remains are Shipped,If Other than Above
E Address
CC
LU
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/16/2022 Registrar of Vital Statistics CynthiaA(Barr(in(E(ectronica((ySigned)
(signature)
District Number 5762 Place Town Of Kingsbury
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
IN ��
Z Date of Disposition ii(I$i7Z Place of Disposition ' e ) _
2 /address/
W
CCCC (section) (lot number) (grave number)
gName of Sexton or Person in Charge of P i s
Z (plate print)
W Signature Title t t'"�
DOH-1555(07/18)p t of 2
r
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#