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Brayton, Buel G g . ?GI— N EW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Buel G.Brayton Male Date of Death Age If Veteran of U.S.Armed Forces, 03/03/2023 89 Years War or Dates p- Place of Death Hospital,Institutiert•or WCity,Town or Village Fort Edward Town Street Address Fort Hudson Nursing Center Inc a Manner of Death 111 Natural Cause Accident Homicide Suicide FlUndetermined El Pending W V Circumstances Investigation W Medical Certifier Name Title a Nicole Humiston NP Address 319 Broadway,Fort Edward Town,New York 12828 Death Certificate Filed Town Of Fort Edward District Number Register Number City,Town or Village 5755 27 Burial Date Cemetery,Crematory or Facility Name 03/06/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation ZO El Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 0- Date Point of Cl)DTransportation Shipment p by Common Carrier Destination EjDisinterment 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 j-•. Remains are Shipped,If Other than Above a Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/06/2023 Registrar of Vital Statistics "lima Lgfalrontyglectronica*Stgne4 (signature) District Number 5755 Place Town Of Fort Edward I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— —, i Z Date of Disposition 3/le 173 Place of Disposition T,..1L f/7 W (address) W CCCC (section) (tot number)( (grave number) /) 74. -- — ywtli S Name of Sexton or Person in Charge of ises ( easeprinr/ Z fr 1 Tv W Signature 7-7./........ Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# Town of Queensbury Certification of Cremation ` 1Y Pine View Cemetery and Crematory This certifies that the remains of: Buel G Brayton were cremated on March , 6 20 23 at the Pine View (Month) (Day) Crematorium, Queensbury,New York, and these are the cremated remains of said body. Date of Death March 3 20 23 Age 89 (Month) (Day) Funeral Home Singleton Sullivan Potter Registered No. 205 (Authorized Signature) BRAYTON Lot No. 8 A Address Glens Falls, N.Y. _ Section No. R.D�#2� Owner George W. Brayton Plot Unadilla Ext. Date 11/13/72 200 Superficial ft. @ $2.00 per sq. ft. Location Roonripa on the Nnrth by Vacant, East by Path, South by Road, West by Road. Corner Posts Remarks Deed No. (and changes) 1240 Payment Record Paid in full 11/13/72 Form No. 01 Record of Interments t George W. Brayton (6/11i/75) Margaret M . Brayton 8/18/00 ! 8 k 1,4 e. /?w i / r,_ G I / r� a 7,5 I ' II %- . ^ /1 � BRAYTON NAME Buel Brayton Age: 89 Lot Owner: George Brayton Lot# Unadi l la Ext. 8A Grave# 5 Case: Urn Died:3 .3 .2 3 Interred:3. 13.23 Funeral Home: Regan Denny Stafford Cemetery: Pine View