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Lescault, Neil J Q175NEW YORK STATE DEPARTMENT OF HEALTH Burial -Transit Permit Bureau of Vital Records Name First Middle Last Sex Neil J Lescault Male Date of Death Age If Veteran of U.S.Armed.Forces, 10/26/2023 49 Years War or Dates F., Place of Death Hospital,Institution or Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital Manner of Death Undetermined Pending W IZNatural Cause Accident Homicide nSuicide g Circumstances Investigation W Medical Certifier Name Title CI Derek Smith 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 619 Burial Date Cemetery,Crematory or Facility Name 10/27/2023 Pineview Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ❑Removal Date Place Removed and/or and/or Held N-- Hold Address 0 d Date Point of N Transportation p by Common Shipment Carrier Destination EiDisinterment 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 0- Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/27/2023 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 Date of Disposition /ZZ , z ZaZ 3 Place of Disposition RAP ' e ) Cre nfq,t�� W (address) UU CC CC (section) (lot number) (grave number) Name of Sexton or Person in Charge of remi s )JCY/37L,, &0OC1 Z -please print) IL Signature / Title 0 e DOH-1555(07/18)p 1 of 2 V �g 7 6 I 0 Public Health Law Sec. 4145(2b) .1�. Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License#