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Denton, Larry A
14— 11-7g NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records —, Name First Middle Last Sex Larry A Denton Male Date of Death Age If Veteran of U.S.Armed Forces, 11/11/2023 63 Years War or Dates i., Place of Death Hospital,Institution or W' City,Town or Village Glens Falls Street Address Glens Falls Hospital W• Manner of Death El Natural Cause Accident El HomicideSuicide Undetermined Pending Circumstances Investigation Q Medical Certifier Name Title Marvin Davidowitz MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 528 Burial Date Cemetery,Crematory or Facility Name 11/13/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0Z Removal Date Place Removed and/or and/or Held F Hold Address N 0 0. Date Point of U)❑Transportation 5by Common Shipment Carrier Destination Disinterment Date Cemetery Address Date Cemetery Address n Reinterment Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom F. Remains are Shipped,If Other than Above 5 Address CC Illl CL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/13/2023 Registrar of Vital Statistics Megan Nolin(ECectronica1Cy Signed) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— • Date of Disposition II I 14123 Place of Disposition ( I► :�L V eg r/llitt FR,Z✓, 2 (address) W N Cr (section) (lot numbed (grave number) QName of Sexton or Person in Charge r mises • ` 1H Ill Z ( (pe print) _ Signature Title `�M 11,7 DOH-1555(07/18)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 burial permit Official Funeral Directors Reg.or License#