Major, Paul Phillip NEW YORK STATE DEPARTMENT OF H EALTH Bu
rial of Vital Records - Transit Permit
Name First Middle Last Sex
Paul Phillip Major Male
Date of Death Age If Veteran of U.S.Armed Forces,
02/01/2023 88 Years War or Dates
f_ Place of Death Hospital,Institution or
Z City,Town or Village Fort Edward Town Street Address 45 North River Road,Fort Edward Town,New York 12828
a Manner of Death Natural Cause []Accident Homicide Suicide Undetermined []Pending
LV ' I
V Circumstances Investigation
0 Medical Certifier Name Title
Robert Lemieux Coroner
Address
415 Lower Main Street,Hudson Falls Village,New York 12839
Death Certificate Filed Town Of Fort Edward District Number Register Number
City,Town or Village 5755 16
Burial Date Cemetery,Crematory or Facility Name
02/03/2023 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
~ Hold Address
CO
0
O. Date Point of
N❑Transportation
p by Common Shipment
Carrier Destination
EiDisinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079
Address
82 Broadway,Fort Edward,New York 12828
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
N Address
C
W
a' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/02/2023 Registrar of Vital Statistics JimeeL WahoneygkctronicallySigned)
(signature)
District Number 5755 Place Town Of Fort Edward
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H
W Date of Disposition Z—t�_zOz3 Place of Disposition P (�eJ C� 4
2 (address)
W
Cl)
M (section) (lot tymber (grave number)
0 Name of Sexton or Person in Charge of Premises Yk9,-✓1D /1/��
Z /(please print)
lL Signature Title ae. `—''J+A
DOH-1555(07/18)p 1 of 2
g. b t:; I
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#