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McNall, Jesse Lynn NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Jesse Lynn McNall Male Date of Death Age If Veteran of U.S.Armed Forces, 08/07/2021 58 Years War or Dates 1981-2001 H Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ©Natural Cause El AccidentEl HomicideSuicide ❑Undetermined Pending ✓ Circumstances Investigation W Medical Certifier Name Title CI Abigail Macomber PA Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 340 ElBurial Date Cemetery,Crematory or Facility Name 08/18/2021 Pine View Crematorium ❑Entombment Address ElCremation Queensbury Town,New York 0 Donation ZZ ❑Removal Date Place Removed and/or and/or Held N Hold Address 0 Date Point of Nj Transportation p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom F. Remains are Shipped,If Other than Above 2 Address CC LU 0' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/16/2021 Registrar of Vital Statistics Robert Andrew Curtis(ECectronicatry 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 Date of Disposition g'i'i'1,� Place of Dispositions AIL w(-t re•� W (address) LU NcC (section) 9 (lot number) (grave number) Q Ln �� � O Name of Sexton or Person in Charge of remises ///��f f 1� W of remises � /p ase print/Signature (S� Title J K DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of ', ; _ _ delivered on r`• , 20 / # ,.• ,;, Pine View Cemetery Representing the funejal home wed on burial permit Official Funeral Directors Reg.or License# `t'l,VI