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Hardman, Edward J Jr.
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Edward J Hardman Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 02/20/2023 82 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Saratoga Springs Street Address 156 Lawrence Avenue 116,Saratoga Springs,New York 12866 '11 p Manner of Death Natural Cause ❑Accident Homicide Suicide Undetermined Pending Circumstances Investigation ILI 0• Medical Certifier Name Title Susan Dorsey MD Address 1 West Avenue,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 125 Burial Date Cemetery,Crematory or Facility Name 02/22/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York ElDonation 0❑Removal Date Place Removed and/or and/or Held i- Hold Address 0 O. Date Point of N❑Transportation p by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Barton-Mcdermott Funeral Home Inc 00141 Address 9 Pine St,Chestertown,New York 12817 Name of Funeral Firm Making Disposition or to Whom i.. Remains are Shipped,If Other than Above a Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/21/2023 Registrar of Vital Statistics DiQott 9Koran(E(ectronicalrySigned) (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 212 I74 Place of Disposition ,fa.— UJ 2 (address) W CC (section) r (/ot.number/ (grave number) O Name of Sexton or Person in Charge of Premises /^ 0 (pease print) W Signature Title iIZRInW(fie DOH-1555(07/18)p 1 of 2 r . •� •� , as 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# •,.