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Briggs, John F Jr.
...fir..- ----- .1 4 4 NEW YORK STATE DEPARTMENT OF HEALTH Burial of Vital Records - Transit Permit Name First Middle Last Sex John F Briggs Jr Male Date of Death Age If Veteran of U.S.Armed Forces, 07/25/2023 47 Years War or Dates F Place of Death Hospital,Institution or WCity,Town or Village Saratoga Springs Street'Mdress Saratoga Hospital 0 Manner of Death El Natural Cause Accident Homicide Suicide ❑Undetermined n Pending W Circumstances I 'Investigation V Wn Medical Certifier Name Title Rome/Gobunsuy MD Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 418 Burial Date Cemetery,Crematory or Facility Name 07/28/2023 Pineview Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation Z''ill Removal Date Place Removed and/or and/or Held I— and/or Address CO 2 CD Ill Transportation Date Point of S by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address Date Cemetery Address ■ Reinterment 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 1— Remains are Shipped,If Other than Above a Address Q W tt' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/27/2023 Registrar of Vital Statistics Dillon Moran(Electronically Signed) (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: Z W Date of Disposition �]-2��D�3 Place of Disposition ��e v`p;,,) Cr�ityl s40 r� (address) W NCC (section) flot nu ber) (grave number) gName of Sexton or Person in 7eofPre7 '\`l 1N D.J r� t L0/please print/ WSi nature Title p PSk as-- g �1. �P DOH-1555(o7/18)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 ttIl a7 permit Official Funeral Directors Reg.or License#