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MacCalman, Duncan Ian
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Duncan Ian MacCalman Male Date of Death Age If Veteran of U.S.Armed Forces, 07/16/2021 91 Years War or Dates Air Force Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death Pending G ©Natural Cause �Accident Homicide Suicide �Undetermined � W Circumstances Investigation W Medical Certifier Name Title CI Shahid Ahmed MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 294 ©Burial Date Cemetery,Crematory or Facility Name 07/20/2021 Pine View Cemetery Entombment Address Cremation Queensbury,New York ElDonation El Removal Date Place Removed and/or Held N and/or Hold Address 0 O. Date Point of (0Transportation Shipment Q by Common Carrier Destination Disinterment 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 H Remains are Shipped,If Other than Above 2 Address re W a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/19/2021 Registrar of Vital Statistics Wp6ert Andrew Curtis(ECectronicalTySigned) (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: IH WDate of Disposition 7/2 0/2 0 21 Place of Disposition 21 Quaker Rd. Queensbury, NY 1 2804 2 (address) W Erie 27D 1 Cle (section) (tot number) (grave number) 0 Connie Goedert Charge Name of Sexton or Person in of Premises Z (please print) Superintendent W Signature Title oe , DOH-1555 l07/18)p 1 of 2 Public Health Law S 4145(2b), 012865 Receipt Human remains of ; ) •t delivered on I 2,0 , 20 4' e View Cemetery I*/t4/ •-•-•-• • Representing the funeral home named otkburial permit Official Funeral Directors Reg.or License# ' i MACCALMAN NAME Duncan Ian MacCalman Age: 91 Lot Owner: Barbara Ann & Duncan MacCalman Lot# Erie 27 D Grave# Case: Concrete Died:7/1 6/2 0 21 Interred:7/2 0/2 0 21 Funeral Home: Singleton Sullivan Potter Cemetery: Pine View