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McNamara, Francis H
a 7°1 NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Francis H.McNamara Male Date of Death Age If Veteran of U.S.Armed Forces, 03/04/2023 81 Years War or Dates 1959-1965 i_ Place of Death Hospital,Institution or Z City,Town or Village Indian Lake Town Street Address 123 WeYo Trail, Indian Lake Town, New York 12842 MI p Manner of Death ZI Natural Cause Accident []Homicide []Suicide Undetermined ElPending W Circumstances Investigation W Medical Certifier Name Title O Melanie Duerr NP Address 47 Tom Phelps Lane, Mineville Hamlet, New York 12996 Death Certificate Filed Town Of Indian Lake District Number Register Number City,Town or Village 2053 1 ElBurial Date Cemetery,Crematory or Facility Name 03/06/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town, New York Donation 0❑Removal Date Place Removed and/or and/or Held ___ ~ Hold Address N 0 d Date Point of f/)[]Transportation p by Common Shipment Carrier Destination o Disinterment Date Cemetery Address 0 Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Miller Funeral Home 01199 Address 6357 Nys Rte#30, Indian Lake, New York 12842 Name of Funeral Firm Making Disposition or to Whom F Remains are Shipped,If Other than Above 2 Address CIC O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/06/2023 Registrar of Vital Statistics Julie A Clawson(Electronically Signed) (signature) District Number 2053 Place Town Of Indian Lake I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: F '•� �� /' Z Date of Disposition _317 113 Place of Disposition -I' \L 11.1 2 (address) W NCC (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premi es �'iy`- - Z (please print) / Ill Signature Title tWage DOH-1555(o7/18)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#