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Blanchette, Joseph Andrew NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records r � 9 6 I Last I Sex Middle Name First Male Joseph Andrew Blanchette Date of Death Age If Veteran of U.S.Armed Forces, 11/27/2023 85 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Johnsburg Town Street Address Elderwood at North Creek W Manner of Death Undetermined Pending tp Natural Cause nAccident I n Homicide Suicide ❑I Circumstances Investigation W Medical Certifier Name Title CI Jennifer Donovan DO Address 112 Ski Bowl Rd,Johnsburg Town,New York 12853 Death Certificate Filed Town Of Johnsburg District Number Register Number 46 City,Town or Village 5655 RBurial Date I Cemetery,Crematory or Facility Name 11/28/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York 0Donation Date Place Removed Removal and/or Held I-- and/or Address CO0 Hold I Point of Cl)❑Transportation Date Shipment p by Common Carrier Destination Date Cemetery Address RDisintennent n Date Cemetery Address I Reinterment Permit Issued to Registration Number Edward L Kelly of Funeral Home Funeral Home 00519 Address PO Box 548,Schroon Lake,New York 12870 Name of Funeral Firm Making Disposition or to Whom i- Remains are Shipped,If Other than Above 2 Address CC UJ 0' Permission is hereby granted to dispose of the human remains described above as indicated. 11/27/2023 Registrar VitalStatistics .7eanAlComs'tack(�Yectronca161,5 m0 Date Issued g (signature) District Number 5655 Place Town Of Johnsburg I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 17 I l 1 Z 3 Place of Disposition ritjf vy Ev ( t MAUJ IUe_- W (address) 1!I (lot number) (grave number) N (section) � T 1 l✓ .vv� O Name of Sexton or Person in Charge of Premises (pl aseprint/ WI h/_: Title M� Signature fat DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) i ' Receipt Human remains of _ delivered on , 20 } Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License#