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Lamphear, Frank Joel NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Frank Joel Lamphear Male Date of Death Age If Veteran of U.S.Armed Forces, 03/12/2024 73 Years War or Dates i_ Place of Death Hospital,Institution or Z- City,Town or Village Long Lake Town Street Address 143 Rt 28, Long Lake Town, New York 13436 pV Manner of Death ❑X Natural Cause Accident ❑Homicide ESuicide [1Undetermined El Pending Circumstances Investigation W Medical Certifier Name Title CI Carl Turner Coroner Address 1188 Main Street,Long Lake Hamlet,New York 12847 Death Certificate Filed Town Of Long Lake District Number Register Number City,Town or Village 2056 1 RBurial Date Cemetery,Crematory or Facility Name 03/15/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation OZ❑Removal Date Place Removed and/or and/or Held H Hold Address ID O. Date Point of (/) Transportation Q by Common Shipment Carrier Destination Date Cemetery Address Disinterment Date Cemetery Address ill Reinterment Permit Issued to Registration Number Name of Funeral Home Miller Funeral Home 01199 Address 6357 Nys Rte#30, Indian Lake,New York 12842 Name of Funeral Firm Making Disposition or to Whom __ Remains are Shipped,If Other than Above 2 Address CC W EL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/15/2024 Registrar of Vital Statistics Amber L Wamback(Electronically Signed) (signature) District Number 2056 Place Town Of Long Lake I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: l— Z Date of Disposition 3/k v, `/ Place of Disposition P;Ale V ei i. C rem 4 p-.q Ill 2 /address) W NCC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge f Premise 1 s /4ri.447^'rb jtj 1 z (please print) IllSignature <7 i _,14' ' Title iterxG4'. 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#