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Cronin, Matthew B licF . NEW YORKSTATE DEPARTMENTOF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Matthew B.Cronin Male Date of Death Age If Veteran of U.S.Armed Forces, 07/03/2023 73 Years War or Dates 1970-1972 F. Place of Death Hospital,Institution or ZCity,Town or Village Moreau Town Street Address 97 Feeder Dam Road, Moreau Town, New York 12803 p Manner of Death EI Natural Cause Accident Homicide OSuicide FlUndetermined ri Pending W Circumstances Investigation U Title W Medical Certifier Name 0 Sonya Blackmer NP Address 2 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed Town Of Moreau District Number Register Number City,Town or Village 4562 34 Burial Date Cemetery,Crematory or Facility Name 07/12/2023 Pine View Crematorium Entombment _ Address ©Cremation Queensbury Town,New York Donation QRemoval Date Place Removed and/or and/or Held H Hold Address N 0 Date Point of Cl)OTransportation Shipment p by Common Carrier Destination El Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above a Address C W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/06/2023 Registrar of Vital Statistics Brenda 7futter(Electronically Signed) (signature) District Number 4562 Place Town Of Moreau I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 7 ly P. Place of Disposition -�i,..� 47____, W (address) W Cl)CC (section) /rot number) (grave number) G Name of Sexton or Person in Charge of Premises ~° 6" _ter l Er (Plea e print/ z0 Crrn, te IlJ Signature Title „.7,,,2 c DOH-1555(07/18)p 1 of 2 A _. Public Health Law Sec. 4145(2b) Receipt i / Human remains of delivered on , 20 ' Pine View Cemetery Representing the funeral home named pn bur permit Official Funeral Directors Reg.or License#