Danahy, Leo NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
gii Name First Middle Last Sex
Mi Leo Charles Danahy male
:; Date of Death : Age If Veteran of U.S.Armed Forces,
Nov. 19, 1991 76 War or Dates yes U.S. Navy
m Place of Death Hospital, Institution or
lit City,Town or Village City of Glens Falls Street Address Glens Falls Hospital
0 Manner of Death.................... g
I4 ® Natural Cause Accident 0 Homicide Suicide Undetermined Pendin
....:...::::..:...............
Circumstances Investigation
lit Medical Certifier .:.:....Name...........::::.:..:.:........:....... Title
p James Morrissey MD
Address
iNi:i90 South Street, Glens Falls, NY 12801
Death Certificate Filed District Number Register Number
City,Town or Village City of Glens Falls 4,'/ ‘75---
Date Cemetery or Crematory
En Burial November 21,1991 Pine View Cemetery
❑Cremation Address Queensbury, New York
z Date Place Removed
0 0 Removal and/or Held
F- and/or Hold ..:::....
Address
N
O...::..:: ........: ...... ::::::_ ......::
a Date Point of
N Transportation by Shipment
p; Common Carrier .......... ......... .......... . .._:::::. ..:..:.
Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Firm Regan and Denny Funeral Service, Inc 01602
Address
N. 26 Quaker Road, Queensbury, New York 12804
.74 Name of Funeral Firm Making Disposition or to Whom
:2]. Remains are Shipped, If Other than Above
Address
373:
ti:
Mg Permission is hereby Granted to dispose of the human emai descr" ed abov 'as indicated.
Date Issued / c:; /- / Registrar of Vital Statistics -
( e)
G
District Number Place yLv�� •�� �A.'
I certify that the remains of the decedent identified above were disposed of in ac dance with this permit on:
-
W Date of Disposition /f-At- / Place of Disposition f z';- /�(=ud (/- 6 7---l°y� �u[2Ns:g u.2 y) A)
n (address)
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CC (section) (lot number) (grave number) .
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p> Name of Sex o Person in Charge of Premises D w y c - /yu s h`2- /z„...
/ (please print)
W Signature ?ei -• ,� Title � ��',
DOH-1555 (10/89) p. 1 of 2 VS-61