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Beebe,Mary-Arthur # )1) NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Mary-Arthur Beebe Female Date of Death Age If Veteran of U.S.Armed Forces, 01/29/2021 80 Years War or Dates Place of Death Hospital,Institution or ZZ City,Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death ©Natural Cause D Accident ❑Homicide Ej Suicide LiUndetermined Pending LU Circumstances Investigation ILI C Medical Certifier Name Title Matthew Loftus PA Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 66 ❑Burial Date Cemetery,Crematory or Facility Name 02/01/2021 Pine View Crematory ID Entombment Address X❑Cremation Queensbury,New York ❑Donation Z Date Place Removed p Li Removal and/or Held and/or COIHold Address 0 CL to ❑Transportation Date Point of Ca by Common Shipment Carrier Destination ElDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom tRemains are Shipped,If Other than Above a Address W 0. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/01/2021 Registrar of Vital Statistics N4,6ertAndrew Curtis(ECectronicalfy Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: z AIL Date of Disposition 2/f /t) Place of Disposition ice, 2 (address) W CO CIC (section) number) (grave number) 8 Name of Sexton or Person in Charge of Prem. ., * �'"A417 Z pteasirint/ W Signature Title DOH-1555(07/18)p i of 2 Public Health Law Sec. 4145(2b) 014483 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#