Hobbs, Earl Louis Jr. •
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Earl Louis Hobbs Jr. Male
Date of Death Age If Veteran of U.S.Armed Forces,
02/04/2023 85 Years War or Dates 1955-1958
Place of Death Hospital,Institution or
W City,Town or Village Glens Falls Street Address The Pines At Glens Falls Center For Nursing&Rehabilitation
pManner of Death n Natural Cause []Accident []Homicide 0Suicide []Undetermined []Pending
C.) Circumstances I 'Investigation
W Medical Certifier Name Title
CI Courtney Diamond NP
Address
170 Warren St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 66
Burial Date Cemetery,Crematory or Facility Name
02/06/2023 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
H Hold Address
0
Date Point of
(t)[]Transportation
by Common Shipment
Carrier Destination
[]Disinterment
Date Cemetery Address
Date Cemetery Address
E Reinterment
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
f.. Remains are Shipped,If Other than Above
2 Address
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 02/06/2023 Registrar of Vital Statistics 1 egan Not-in(E(ectr-onicatTySigned)
(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
W Date of Disposition Zip_Z02 Jz Place of Disposition AiLo /re C 4:.),q
2 (address)
W
N
Q (section) (lot numb ) (grave number)
• Name of Sexton or Person in Charg f Prem. s K147 61 e,/ Aloeri
Z (please print)
lL Signature � Title oe-f,A4'r-
DOH-1555(018)p 1 of 2
T. 1,. ''s•7
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#