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Paradis Jr., James J 613,E NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex James J.Paradis Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 05/20/2023 78 Years War or Dates 1963-1965 Place of Death Hospital,Institution or Z City,Town or Village Kingsbury Town Street Address 335 Geer Road, Kingsbury Town, New York 12839 UJ Manner of Death a Natural Cause Accident 0 Homicide Suicide ❑Undetermined Pending UCircumstances Investigation WO Medical Certifier Name Title William Parker MD Address 9 Carey Road,Queensbury Town, New York 12804 Death Certificate Filed Town Of Kingsbury District Number Register Number City,Town or Village 5762 10 Burial Date Cemetery,Crematory or Facility Name 05/22/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held i- Hold Address 0 G. Date Point of !t) Transportation 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 12i 39 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above 5 Address E W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/22/2023 Registrar of Vital Statistics CynthiaA Bardn(Electronically Signed) (signature) District Number 5762 Place Town Of Kingsbury I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 3T/2j,173 Place of Disposition 2 (address) W N (section) d (lot number (grave number) 8 Name of Sexton or Person in Charge of Premi es Z please print) !L Signature Title l► 4#irw 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#