Manaher, Donald NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Donald J. Manaher Male
Dates Death Age If Veteran of U.S. Armed Forces,
3 August 6,2011 89 War or Dates
Place of Death Hospital, Institution or
City, Town or Village Street Address
Manner of Death I Al Natural Cause I l Accident [I]Homicide n Suicide Undetermined i Pending
'—Circumstances Investigation
Medical Certifier Name Title
Robert Sponzo,MD
Address
Glens Falls,NY
Death Certificate Filed District Number Registerpi-umber
City,Town or Village Queensbury,NY 5657 7
®Burial Date Cemetery or Crematory
0 Entombment August 9,2011 Pine View Cemetery
Address
❑Cremation Quaker Road,Queesnbury,NY
Date Place Removed
C n Removal and/or Held
and/or Address
Hold
Date Point of
5 n Transportation Shipment
5 by Common Destination
Carrier
Disinterment
Date Cemetery Address
II]Reinterment
Date Cemetery Address
Permit Issued to Registration Number
ii Name of Funeral Home Singleton-Healy Funeral Home
01596
Address
F 407 Bay Road,Queensbury,NY 12804
Name of Funeral F M Othering Disposition than Above or to Whom
• Remains are Shipped,
• Address
•
Permission is hereby granted to dispose of
the human remain described above as ndicated.
f/ Registrar of Vital Statistics 1
Date Issued ( gnature)
:_ District Number 5657 Place ueensbu NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
}' 8/9/2011 Place of Disposition Pine View Cemeetry
(address) 4
W Date of Disposition �� 4 2 C
w Mohican (lot number) (grave number)
W (section)
r
erson in Charge of Premises Michael Genier (please print)
CName of Sexton or Title Su erintendent
Z (over)
W Signature
DOH-1555(o2/2004)