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Girard, Philip M 5„ NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Philip M Girard Male Date of Death Age If Veteran of U.S.Armed Forces, 07/24/2023 35 Years War or Dates (.. Place of Death Hospital,Institution or WCity,Town or Village Corinth Village Street Address 133 Main Street 3,Corinth Village,New York 12822 `p Manner of Death Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation U,1 Medical Certifier Name Title David DeCelle Coroner Address 40 McMaster Street,Ballston Spa,New York 12020 Death Certificate Filed Town Of Corinth District Number Register Number City,Town or Village 4553 13 Burial. Date Cemetery,Crematory or Facility Name 07/27/2023 Pineview Crematory Entombment Address ©Cremation Queensbury Town,New York Donation OZ❑Removal Date Place Removed and/or and/or Held F. Hold Address N 0 Date Point of U)❑Transportation a by Common Shipment Carrier Destination O Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom }. Remains are Shipped,If Other than Above a Address CC W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/26/2023 Registrar of Vital Statistics Brenda L Peris(Electronically Signed) (signature) District Number 4553 Place Town Of Corinth I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition 7 I Z)113 Place of Disposition 'FbV (address, W CC CC (section) liotnumber) (grave number) aName of Sexton or Person in Charge of P is s t frt z (plea print) W re&in#1 4H Signature Title DOH-1555(o7h8)p 1 of 2 . .-- b fig, Public Health Law Sec. 4145(2b) ' ' ' x Receipt Human remains of delivered on , 20 1 Pine View Cemetery Representing the funeral home name4onsrial•permit. Official Funeral Directors Reg.or License#