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Morin, Denis J LF NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Denis J.Morin Male Date of Death Age If Veteran of U.S.Armed Forces, 12/19/2023 75 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Thurman Town Street Address 328 Mud Street,Thurman Town, New York 12810 111 `p Manner of Death El Natural Cause Accident ❑Homicide 0 Suicide Undetermined ElPending Circumstances Investigation W Medical Certifier Name Title a David Cunningham MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed Town Of Thurman District Number Register Number City,Town or Village 5659 8 Burial Date Cemetery,Crematory or Facility Name 12/21/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation g❑Removal Date Place Removed and/or and/or Held p N Hold Address 0 d Date Point of (1) Transportation p by Common Shipment Carrier Destination 11 Disinterment Date Cemetery Address Reinterment Date Cemetery Address 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 1- Remains are Shipped,If Other than Above 5 Address CC LU O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/21/2023 Registrar of Vital Statistics Cynthia W;.gryde(ECectronicalrySigned) (signature) District Number 5659 Place Town Of Thurman I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: f- Z Date of Disposition /Z-ZZ-2e.,Z3 Place of Disposition f?„Je U;r e,� (address) W (I) CC (section) `� (lot number) (grave number) gName of Sexton or Person in Charge o remiss ' `dY1/0.' Z i (please print) W Signature - " JJ/ Title �,PJ—g'ts� DOH-1555(07/18)p t of 2 t 1,( IY i.,_( 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#