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Arney, Joseph J. — w► NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Joseph J.Arney Male Date of Death Age If Veteran of U.S.Armed Forces, 07/28/2021 74 Years War or Dates Vietnam .. Place of Death Hospital,Institution or Z City,Town or Village Colonie Town Street Address Perigrine Landing p Manner of Death © Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending W U Circumstances Investigation W Medical Certifier Name Title David Cunningham MD Address 3 Irongate Center,Glens Falls, New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Colonie Town 0153 207 ❑Burial Date Cemetery,Crematory or Facility Name 07/29/2021 Pine View Crematory ❑Entombment Address ICremation Queensbury Town, New York ❑Donation OZ ❑Removal Date Place Removed and/or and/or Held - Hold Address 0 O. 1-1 Date Point of co ❑Transportation p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 Address 24 Church Street PO Box 500,Lake Luzerne,New York 12846 Name of Funeral Firm Making Disposition or to Whom F— Remains are Shipped,If Other than Above -t Address CC W 0- Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/29/2021 Registrar of Vital Statistics Julie L Gansle(Electronically Signed) (signature) District Number 0153 Place Colonie Town, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I- Z Date of Disposition 7'?.5.-jl►),,1 Place of Disposition e jyu, v;GW c rtmq rY 2 (address) W Et U) (section) (lot number) (grave number) 0 Name of Sexton or Perso in C arge of Premises .'" C 'Y SQ14'�f�3 (please print) W Signature Title Grt►,.4k< DOH-1555(07/18)p 1 of 2 iro Public Health Law Sec. 4145(2b) 01 9 . Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#