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Murphy, Michael L NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Michael L.Murphy Male Date of Death Age If Veteran of U.S.Armed Forces, 07/27/2023 64 Years War or Dates Marines 1— Place of Death Hospital,Institution or Z City,Town or Village Hudson Falls Village Street Address 19 Elizabeth Street, Hudson Falls Village,New York 12839 eiManner of Death X❑Natural Cause Accident El Homicide Suicide El Undetermined El Pending W C.) Circumstances Investigation G Medical Certifier Name Title 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 25 Burial Date Cemetery,Crematory or Facility Name 07/29/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held F- Hold Address N 0 a Date Point of U)❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above 2 Address cr W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/28/2023 Registrar of Vital Statistics Cynthia Bardin(ECectronicafySigned) (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: Z uJ Date of Disposition Z ZoZ3 Place of Disposition e ii�e(...1 Cre-neei`st (address) l W Cl) /1 (section) (lot number) 1 (grave number) SName of Sexton or Person in Charge of P mise,,/ 4 Y'I'll D n1 ) Oc29 C! z , (please print) W Signature �e k" Title qe `� DOH-1555(07/18)p 1 of 2 / 67, Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pme'(fiew Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#