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Planty, Jeffrey E
d NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Jeffrey E.Planty Male Date of Death Age If Veteran of U.S.Armed Forces, 09/07/2023 68 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address 11 Charlotte Street,Glens Falls,New York 12801 p Manner of Death �Natural Cause Accident EI Homicide Suicide Undetermined Pending Circumstances Investigation GMedical Certifier Name Title William Parker MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 426 Burial Date Cemetery,Crematory or Facility Name 09/12/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation Removal Date Place Removed and/or and/or Held H Hold Address O Q. Date Point of N oTransportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address OReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg, New York 12885 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above S Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/11/2023 Registrar of Vital Statistics Megan Nolin(ECectronica1Ty 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: W Date of Disposition cj(tti7; Place of Disposition 2 (address) W N CC (section) "(lot number) (grave number) 8 Name of Sexton or Person in Charge of Pre ises ,)� Z (p1 se print) W Signature Title 's DOH-1555(07/18)p id 2 Public Health Law Sec. 4145(2b) Receipt Human remains of `� l� delivered on , 20 ' • 'Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#