Deeb, Joseph NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joseph L. Deeb Male
Date of Death Age If Veteran of U.S.Armed Forces,
September 21,2006 76 War or Dates N/A
Fo. Place of Death City of Glens Falls Hospital, Institution or Glens Falls Hospital
z` City, Town or Village Street Address
Manner of Death Q Natural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined ❑ Pending
Ci
Circumstances Investigation
0 Medical Certifier Name Title
ILL Sean Bain Dr.
a Address
100 Park St,Glens Falls,NY 12801
Death Certificate Filed District Number Register,Np 1ber
City, Town or Village Glens Falls 5601 44 6
0 Burial Date Cemetery or Crematory
9/25/2006 Pine View Cremation
0 Entombment Address
1 I Cremation Queensbury,NY
Date Place Removed
Z 0 Removal and/or Held
p and/or Address
E Hold
N Date Point of
a ❑ Transportation _ Shipment
N by Common Destination
G Carrier
Date Cemetery Address
❑ Disinterment
Date Cemetery Address
❑ Reinterment
Permit Issued to Registration Number
Name of Funeral Home Singleton-Healy Funeral Home 01682
Address
407 Bay Road,Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
u tm
a. Permission is hereby grrantted to dispose of the human remains descr" ed bo e a dic .
Z Date Issued 9/ 2l 0-6 Registrar of Vital Statistics / �`
(signature)
District Number 5601 Place Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
1-
Z Date of Disposition 9//(,/o', Place of Disposition (din,,t w Cr.vr,.5,f or; ,;..,,
W (address)
W
N (section) (lot number) (grave number)
Ce
O Name of Sexton or Person in Charge of Premises Cl.. r" SI h ont
Z (please print)
W Signature (. 1 .� '�"'^rV Title CV h.<i or
DOH-1555(02/2004) (over)