Linnard, Michael Murray NEWYORKSTATEDEPARTMENTOFHEALTH Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
Michael Murray Linnard Male
Date of Death Age If Veteran of U.S.Armed Forces,
12/20/2022 61 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital
W
p Manner of Death M Natural Cause []Accident ❑Homicide {]Suicide nUndetermined Pending
lL Circumstances Investigation
W Medical Certifier Name Title
p Derek Smith MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed City Of Saratoga Springs District Number Register Number
City,Town or Village 4501 753
[]Burial Date Cemetery,Crematory or Facility Name
12/21/2022 Pine View Cemetery and Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
OZ❑Removal Date Place Removed
and/or and/or Held
Hold Address
0
a Date Point of
t/) Transportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
[]Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home William J Burke&Sons Funeral Home 01827
Address
628 N Broadway,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/21/2022 Registrar of Vital Statistics Dirron Moran(ECectronica1Ty Signed)
(signature)
District Number 4501 Place City Of Saratoga Springs
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition jZ-7Z-ZZL Place of Disposition ?,` �P . e,) (2ir-e'.rflei t-
ill
2 (address)
W
CC N
(section) (lot nu nber) (grave number)
Name of Sexton or Person in Charge f Premises
Z please print)
W '
Signature I 1"/ Title reC-4.4e'r—
DOH-1555(07/18)p i of 2
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#