Parrow, Edmund E Jr, I
J ..
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
5 Edmund E.Parrow Jr Male
Date of Death Age If Veteran of U.S.Armed Forces,
07/21/2022 79 Years War or Dates Navy
E Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address 6 Cottage Place,Glens Falls, New York 12801
e Manner of Death ID Natural Cause Accident Ej Homicide ESuicide Undetermined ❑Pending
V Circumstances Investigation
eau Medical Certifier Name Title
Gerard Abess MD
Address
3 Irongate Center,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 378
Burial Date Cemetery,Crematory or Facility Name
07/22/2022 Pine View Crematory
Entombment Address
Cremation Queensbury,New York
;Donation
❑Removal Date Place Removed
gand/or and/or Held
Hold Address
2 Date Point of
U)a
Transportation
by Common Shipment
Carrier Destination
Date Cemetery Address
Disinterment
Reinterment Date Cemetery Address
rt 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
tut Remains are Shipped,If Other than Above
Address
4 Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 07/21/2022 Registrar of Vital Statistics Megan Wolin(ECectronwa/Iy Signed)
(signature)
District Number 5601 Place City Of Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition Z 23 ZplZ Place of Disposition —P°lie (,✓ er
tu
r1�,10 ti�
W' (address)
H
8 Q (section) II ff (lot number) J (grave number)
Name of Sexton or Person in Charge f Prem. es i''" r!'r/UN b cod
`ZLI �` r (please print)
Signature � ./ Title oe„,-
DOH-1555(o7/18)p t of 2 v
Public Health Law Sec. 4145(2b)
1 Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#