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Dean, Kevin M Vele,� NEW YORK STATE DEPARTMENT OF HEALTH Burial- Transit Permit Bureau of Vital Records Name First Middle last Sex Kevin M Dean Male Date of Death Age If Veteran of U.S.Armed Forces, 08/26/2023 58 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Queensbury Town Street Address Glens Falls Center for Rehabilitation and Nursing aManner of Death Z Natural Cause DAccident Ej Homicide Suicide FlUndetermined ri Pending W Circumstances Investigation E Medical Certifier Name Title Wendy Steinhacker PA Address 152 Sherman Ave,Queensbury Town,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 134 Burial Date Cemetery,Crematory or Facility Name 08/28/2023 Pineview Crematorium 1._, Entombment Address et ely. ©Cremation Queensbury Town,New York :bi';, l Donation Z Removal Date Place Removed � 'and/or and/or Held • • No Hold Address 2 Date Point of CA❑Transportation Shipment S by Common Carrier Destination Date Cemetery Address • ❑Disinterment ElReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Radloff Funeral Home Inc 01425 Address 136 Warren St,Glens Falls,New York 12801 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address Q W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/28/2023 Registrar of Vital Statistics Caroline Hildegarde Barber(Electronically 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 30-7.6z3 Place of Disposition U"► Je i/;e .) C iu 2 (address) it (section) (lot nu ber) i (grave number) Oz Name of Sexton or Person in Charge o remi -\ y/�d 1Z'D� (please print) W Signature -frou Title DOH-1555(o7/t8)p 1 of 2 '94. 4 Public Health Law Sec. 4145(2b) Receipt Human remains of t" delivered on , 20 Pine View Cemetery Representing the funeral home namedpn bbirialpe mit Official Funeral Directors Reg.or License# °