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Hunt, Donald Leonard NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Donald Leonard Hunt Male Date of Death Age If Veteran of U.S.Armed Forces, 01/08/2022 88 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Queensbury Town Street Address 415 Luzerne Road,Queensbury Town,New York 12804 p Manner of Death II Natural Cause ❑Accident ❑Homicide ❑Suicide El Undetermined Pending Circumstances Investigation WMedical Certifier Name Title G Melanie Duerr NP Address 47 Tom Phelps Lane,Mineville Hamlet,New York 12996 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 5657 6 ©Burial Date Cemetery,Crematory or Facility Name 01/11/2022 Pine View Cemetery ❑Entombment Address ❑Cremation Queensbury Town,New York ❑Donation O Removal Date Place Removed and/or and/or Held N Hold Address 0 U. Date Point of +N ❑Transportation p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom �.. Remains are Shipped,If Other than Above a Address 'U Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/10/2022 Registrar of Vital Statistics Carolinexaigard Baner(Electronicaf Stgne4 (signature) District Number 5657 Place Queensbury, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: �l jQ4 RJ Z Date of Disposition ,. � �. as Place of Disposition a� [,f�5 [,tr� /Y L /o78y (address) w cc► !� rn (sedio (lot number (grave number) gName of Sext Person in Charge of Premises i'S-11-11 e (c leas t v W / Z y7 Signature l2 e Q SZ Titled111 DOH-1555(07/18)p 1 of 2 HUNT NAME Donald Hunt g A e: 88 Lot Owner: Donald & Joanne Hunt Lot# Seneca 5A Grave# 2 Case: Concrete Died: 1 .8.2 2 Interred: 1 . 1 1 .2 2 Funeral Home: Regan Denny Stafford Cemetery: Pine View Public Health Law Sec.4145(2b) 012898 Receipt Human remains of - delivered on , 20 //4 • 1iine View CemeterY--,.— Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#