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O'Hanlon, Jeanne M.
Pine View Cemetery $ Crematorium Quaker Road Queensburyl NV 12804 (518) 745-4477 Or (518) 745-4476 FUNERAL HOME: __ _nB-__...U_. .w _.- ---.__._._. RETURN TIME: DATE S TIME REMAINS ARRIVED AT CREMATORY: NAME OF FUNERAL DIRECTOR OR gEGRISTERED RESIDENT DELI VE VEglN6 REMAINS: NAME: ._..._._. a PF Q'H(L JN_._ _ _CASE p TYPE OF CONTAINER: "011 as ad PLACE OF DEATH: _ J�qF_ _ (4L_ . . ESTIMATED WEIGHT OF REMAINS R CONTAINER___ _ jSp PLACED IN HOLD: _ —�---- _ ____ IZ�ro il.. PLACED IN REFRIGERATION: __ DATE OF CREMATION: + ,y� TIME STARTED: __ _ �jD . At —TIME COMPLETED: _ 4:Pf Cr) PLACED IN RETORT: _ � -- RETORT 9 IN WH ICH REMAINS WERE CREMATED: DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS FROM TIME OF ACCEPTED DELIVERY: NOTE: THE CREMATION LOG SHALL HE RETAINED IN THE PERMANENT FILE Of TRe CREMATORY. D.wdw.YQr Sw1 NEW YORK i)IVISIOII Of taNIBgH OF CCEMMRIES ft STATE GF N PPO0.N"'TM Cemeteries Xhmi 31re"1 7,uphane.1518l e7116226 Authorization for Cremation and Disposition THIN Au~nfron Few must the completed and Sgl piw b delivery a usual for centre . Dale August 17 2020 Number'. 32 Cmmelwy,Nane'. Cremebry NMreae: 21 Quaker Road Oueens gNew York 1280a pmpe, 518-7451 CRE"M ON IS AN IRREWRSIaLE AND FINAL PROCESS. Cremations caned me by gaong the remains mIts deceased and Me consulter meant the remains Into a moral chamber one "yam subjected to intense heal and flame. The Nat and flame"Iincinerate and consume ewryMlrg damp bone end mml, w chom2li MatwillblMafbrcmnation. Following crem el be crematory anti We reasonable eMadeb remove ail of Me remains and Other malenal from the member chamber, but seem minimal dust and residue will likely be ad Mhind. Tim crematory all separate incidenml and foreign na edal from 1R remains and Me Inodental and foreign materiel val be disposed of as mankind by new The uemAed manams will m m ncra ody pubedmdInto small pieces and placed Into a designated common um. CmmabdmmMnpenerallyarepulvOmv undlno single"Went remarkable As OWN ldmue. OPENING OF THE CONTMNER The crematory may only open the container holding the unCBmal human remains in limited circumstances, such as to confine the many athe deceased orb enure that no martial Is enclosed whom might mum employees cur damage the crematory property. If human mmpns are delivered In a container which is net suitable for rnmedon such as ceremonial or all casket Me mmalmy will deal Met me remains N moved Irrtd a sui ate*container Wl It ecmpb Me mankind. The operdng ot a centers,or the bander or removal of remains will be conducted before a witness and cull be done In privacy, men dignity and names. IDENTIFICATION OF DECEASED Nam" Emddamd: matnm M. O'Hanbn Mena Sears O'wrad Last Known Ark rem: a Madison Sl. Apt. t Glen¢Fals, New York 12801 Plea of Dan , Glenn Fell Pull 1W pairs EL Glenn Fall New Yank 128M Sex'. O M © F Age:89 DDs: 09-14-1930 D &D"th 08-15-2020 EMirmled R 9M 150 Laeoiwion of mssmiddr amerin warm rename all be delivered. Florence Casket, plywood corrugated cardboard container. OF DISPOSVION (Perm+(a)m cvMM Of m p new, "am LOW: or Me Mbwirg) I aMWe are Me designated agent re the UBtedmd designated in a will or written instrument executed pursuant to Pudk Heats taw Setlbn 4201. OF- NJe ham m knowledge tat the metal executed a women mammal pursuant b Purse health Las SeNon 6201 ma MII demanding areal for be dmpoeman an his cur her remains and mad am the peradmic having M«ity under Public Health Law Scheme 4201 one have Me ri M aalhove Nobel of the remans of Me deceased. Myi miasmal Ad Me demaead m as fabwa: Jeanne M. O'Hanlon DOG-1S58-f(Rev.germ) Page 1 Ma Authorization for Cremation and Disposition halo Ins blbwmv di li Indurated that IF Me remains am not claimed when 1X days Of strengthen, Pore vim Crematory mayat a�dcassil awa m me m mamalm an eretnevehle sharer, soon as by amusing CREMATION CONTAINERIORN (atrial ONE&Ma/ramarr ) An um W ba and as a¢Other for the pemMd remains has bean purchased hom M. B. Know Funeral Nome and is desmbed as fgnars IAfm understand Met IF the Ion is MO emBll to band the were uemeW remains, an addi mal d9M COnlainer my be dead for density. -0& an ten isnet ye purNe98d. IM{T underwear MiI no um is purchased or otherwise provided pine View Dramatry wall place the Qamatad r.mam¢t nwnwrw.ur a had tmporary mManer for defvwy Th'n A dminamon Farm am prowded any cure G Kmopke was executed at Pusaawmi M. eKIImw FurMel Home 136 Mein Sl Sound Glens Fells, N"YoA 1 & avruxw exnl and is named by the heard director as xrbreuW Hs examon,, li IKve removed a completed way of this Authorization Farm. The perean s)MwNPed below &are tie pandM¢)In wnbol NdtpoeMan,who by signing th sAUMwizad"Farm, aweeei to am misun" and awnpletnwe adMe submitted deemed In that Amermlemon Farm and euMortaele)the foregone. Signed Mn 17 48Y Of August re 30 Gwen OHanon r15 Zerna Dora OueensWry, New York 128N amass rwrcpnmo ... saws WITNESS: / Ctalre C. Konnsi Cl/� _ e vtt M 019J3 .ed «mm.erv.mu M++wwaa++mt o-u JeenreWO'Hanlon Iraer✓>wh DOS 189"IRes. OalPM Pi 3ad3 Authorization for Cremation and Disposition pruertlmm Me lief bebwf Numdm- 5 Oeermim: Am su menO child el0hteen years of age a okter. 2 The designated in writing pur¢ to PublicH h Law Madden d20113)', weaving spouse so. The moaning tlwni pats r, 3. Any sending t chi maker Amend;of age a older; A A 9. A wrvwing siring eighteen years of age W Other S. ANwlully SPPoiM dguutllan', e. AaNya Pngredeen years of time or Oder emMea m share in OMi and who Isom Cklwd m relouress p to the backwuea; pgvmM nai Of the ealeta: 9. A does Mend Or relawky who has mail a smash slatemenl pursuant to PU Wake Heats taw 59clron 4201f�', 10. A oriel fiscal officer of a coundy or a public administrator sediment puRW nt to the Su ntgat Court Procedure Aci Wa. Any older person who is dong on We R of the chadded and who has executed a wlillm statement pursuant to Pudic HemM Law SMbn 4201(7). G�pALL THREE dike IwyoaHgl 404i Arne herby affirm Mat the body of the boom ed does not meld a battery, b flaq pats, power cell, mdmctid imosM w Monday Monaco and that my and Meadow were remwN prior b Me"x On of he$4 oriaa0on Form. Failure ro dramas B sMMend comes to Cremation may result in Mmt ro tecmnatory and mmabry"mmmi. Age affirm tNlIn¢trucana revs been grand b Clam Kmropka rtyamng the removal of a"Fer¢mwl Preperry m oMp Mine of who,whi any person siturg bakes rvem femrM member of They demmedmAe¢topresave. Piney Cremmory is nN responses for Me rerrovaiW ttxi amry mmr pe9onal items from Me contend w kemberemans Ol Medeceased. POMOMlibmele inibs Margaret de wham the moraine wall be deboyetl by Me crama0on process and canna Mr be demanded a cremation. x,)C,01`)'A'YfLr_,gvs herby Mhon Pine View Cremetory ro Maw to mdamag Me mnalre of Me deme..ee. r(M' L ovnoNaq Its hereby atMoner Me named formal direcmr b pravide for tlnlvery to and cmmaaon by an algmate mnamry, if deemed!necessary In Me opinion of Me Moody dmmo ,, and b amend and form to provide Me commit name add "time M such aerate Model FINALOMS Srt ON The person atromed to reeIXve Me a cam remains of the dettaeed from Me crematory Ian Name: M. B. Kdrer Fumml HpM Ad s: IM Main 5l. Smuts Game FMls, New York 12803 Phan: 518-745 113 TM vemeMd rsMiM of tleceaxM MII be d i¢Mased of ee bikers: Processor to hw daughter raWm O'HaNm HM my random the peeon named abuse does M take posw¢Mon ofMe ere amend. Pike VIM Cr om x.�. nauMp to giver pa¢¢e¢ mOt Its remains to M. B. Mind Funmal Homes try"i in Person Or by rpi¢Imed mail. YwrrrJ. Jamnn et M. OHenlon O09-1891 gi 011 Page 2 of3