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O'Malley, Brenda Lee
6-in,\ NEW YORK STATE DEPARTMENT OF HEALTH /�f Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Brenda Lee O'Malley Female Date of Death Age If Veteran of U.S.Armed Forces, 08/31/2023 65 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Queensbury Town Street Address 65 Hawk Road,Queensbury Town,New York 12804 Manner of Death Natural Cause Accident Homicide EI Suicide Undetermined Pending 1i1 Circumstances Investigation 14 Medical Certifier Name Title Christopher Mason DO Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 140 Burial Date Cemetery,Crematory or Facility Name 09/06/2023 Pine View Crematory Entombment — Address ©Cremation Queensbury Town,New York ` Donation Z Removal Date Place Removed 0 and/or _ and/or Held F- Hold Address to 0 d Date Point of UC Transportation a by Common Shipment Carrier Destination Disinterment El Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address IL id IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/06/2023 Registrar of Vital Statistics Caroline xfiegarde Bar6er(ECectronicalTy Signed) (signature) District Number 5657 Place Town Of Queensbury I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 118i 13 Place of Disposition11.1 ti(L 4,— a (address) iW l (section) (lot number) svv, (grave number) g : : °' ame f Sext or Person in Charge of P ises ^'' j1� Z /p/4 e print/ILI ' re Title 1 �� DOH-1555(07/18)p 1 of 2 A.. 4i 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#