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Lapointe, Bruce D
NEW YORK STATE DEPARTMENT OF HEALTH J ,� Burial - Transit Permit Bureau of Vital Records F Name First Middle Last Sex Bruce D.LaPointe Male Date of Death Age If Veteran of U.S.Armed Forces, 02/29/2024 68 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Queensbury Town Street Address 21 Wayne Court, Queensbury Town, New York 12804 W Manner of Death El Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title G Timothy Murphy Coroner Address 52 Haviland Avenue,Glens Falls,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 35 Burial Date Cemetery,Crematory or Facility Name 03/02/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donationgn Removal Date Place Removed and/or and/or Held H Hold Address N 0 a Date Point of to Transportation $ by Common Shipment Carrier Destination EIDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address CC W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/01/2024 Registrar of Vital Statistics Caroline xllegaree Barber(E(ectronicaCCy Signed) (signature) District Number 5657 Place Town Of Queensbury I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition YC ►(� p �-v��aa,.z� Place of Disposition (�(. f oy/ Cr-01 61.4'� 2 (address) W CC (section) (lot nu r) (grave number) 8 Name of Sexton or Person in Charge of remiss ar/Oni (please print) W Signature ` A Title O6QTA, DOH-1555(07/18)p l of 2 + j •y � 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#