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Schmitt, James Edward ..,. LF # igti NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex James Edward Schmitt Male Date of Death Age If Veteran of U.S.Armed Forces, 02/19/2023 61 Years War or Dates F Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death EINatural CauseAccident Homicide Suicide Undetermined El Pending W V Circumstances Investigation 0111 Medical Certifier Name Title Bo Li MD Address 100 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 97 BurialEl " Date Cemetery,Crematory or Facility Name 02/22/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation goRemoval Date Place Removed H and/or and/or Held N Hold Address 0 Q. Date Point of Cl) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address 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 i— Remains are Shipped,If Other than Above IAddress uJ • a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/21/2023 Registrar of Vital Statistics Megan Wolin(ECectronicaCCySigned) (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 2'74li, Place of Disposition �v 46,T. 2 address) W Cr N (section/ dile(lot (`number) (grave number) SName of Sexton or Person in Charge of Premises Z / ease print/ W Signature Title CfZFm1►lT°2 DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named/on htfrialpervnit Official Funeral Directors Reg.or License#