Loading...
Wood, Timothy Charles NEW YORK ST DEPARTMENT OF HEALTH Bureatiof Vital records• Burial - Transit Permit Name Middle Last Sex Timothy Charles Wood Male Date of Death Age If Veteran of U.S.Armed Forces, 10/08/2023 62 Years War or Dates ZPlace of Death Hospital,Institution or Z City,Town or Village Argyle Town Street Address 126 Durkeetown Road,Argyle Town, New York 12809 'p Manner of Death JJNatural Cause Accident []Homicide []Suicide []Undetermined []Pending C.) ;� I (Circumstances f 'Investigation 0 Medical Certifier Name Title Robert Lemieux Coroner Address 415 Lower Main Street,Hudson Falls Village,New York 12839 Death Certificate Filed Town Of Argyle District Number Register Number City,Town or Village 5750 46 Burial Date Cemetery,Crematory or Facility Name 10/10/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York - Donation Z Removal L.JDate Place Removed and/or and/or Held - Hold Address 0 to Transportation Date Point of by Common Shipment Carrier Destination ODisinterment 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 12839 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above 2 Address W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/10/2023 Registrar of Vital Statistics Shelley 9t1ckernon(Efectronica1Ty Signed) (signature) District Number 5750 Place Town Of Argyle I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition /01ll1�7; Place of Disposition .:, W (address) W it (section) (lotnu • (grave number) Ci Name of Sexton or Person in Charge of Premises n� —^ 4 rl Z (p ease print) LLJ Signature Title 6M� DOH-1555(07/18)p 1 of 2 -_ ,• ( r) Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 • Pine View Cemetery Representing the funeral home named Qn.purial permit Official Funeral Directors Reg.or License#