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McNaughton, Joshua Harrison 4 n3 NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Joshua Harrison McNaughton Male Date of Death Age If Veteran of U.S.Armed Forces, 04/21/2023 40 Years War or Dates i_ Place of Death Hospital,Institution or Z City,Town or Village Hudson Falls Village Street Address 12 Juckett Drive, Hudson Falls Village, New York 12839 iii p Manner of Death ❑Natural Cause Accident []Homicide nSuicide Undetermined Fa Pending ILCircumstances I=IIInvestigation U W Medical Certifier Name Title CI Robert Lemieux Coroner Address 415 Lower Main Street,Hudson Falls Village,New York 12839 Death Certificate Filed Village Of Hudson Falls District Number Register Number City,Town or Village 5726 10 Burial Date Cemetery,Crematory or Facility Name R 04/25/2023 Pine View Crematorium Entombment Address — ©Cremation Queensbury Town,New York Donation Z Removal Date Place Removed - and/or and/or Held H- Hold Address CO 0 d Date Point of Cl) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address El 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 f_ Remains are Shipped,If Other than Above 5 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/24/2023 Registrar of Vital Statistics Cynthia_(Bardin(ECectronicaliySigned) (signature) District Number 5726 Place Village Of Hudson Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— Z Date of Disposition y/4 173 Place of Disposition f i...V.— Zt.or--- 2 (address) W U) Lt (section) 7 (lot number) (grave number) 0 ::::::: °" or Person in Charge of Premi ease print) l a Title 11eFina{ � 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 burial permit Official Funeral Directors Reg. or License#—