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Reardon, Kenneth Charles
(1,... ) NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Kenneth Charles Reardon Male Date of Death Age If Veteran of U.S.Armed Forces, 06/09/2023 68 Years War or Dates i_ Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital W Manner of Death Undetermined Pending W Natural Cause Accident Homicide Suicide Circumstances Investigation W Medical Certifier Name Title 0 Melody Long PA Address 100 Park Street,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 293 EBurial Date Cemetery,Crematory or Facility Name 06/12/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 O. Date Point of Cl)nTransportation Shipment 5 by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom F. Remains are Shipped,If Other than Above 2 Address OC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/12/2023 Registrar of Vital Statistics Megan Nolin(Electronically 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:~ (.-)1"--- W Date of Disposition Co((p�(�)Z3 Place of Disposition ��L ddress) W N CC (section) !ot number/ c (grave number) gName of Sexton or Person in Charge of P mises (pi a print/ ,_-• alN Signature Title il/a< 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#