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Manney, Edward L Jr. c: got NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Edward L.Manney Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 10/04/2023 86 Years War or Dates F. Place of Death Hospital,Institution or W City,Town or Village Queensbury Town Street Address 21 Warren Street,Queensbury Town,New York 12839 p Manner of Death El Natural Cause Accident ❑Homicide OSuicide Undetermined Pending ✓ Circumstances Investigation WG Medical Certifier Name Title Darci Gaiotti-Grubbs MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 155 Burial Date Cemetery,Crematory or Facility Name 10/06/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation ❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 O. Date Point of (I) Transportation ES Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom F— Remains are Shipped,If Other than Above N Address Q W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/05/2023 Registrar of Vital Statistics Carolinexkkgari BanergYectronica8 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: iu Date of Disposition /v 7--ZO23 Place of Disposition 4 e V:-e 2 (address) W CO CIC (section) (lot num r) (grave number) aName of Sexton or Person in Charge of P misest�'�/ylfs.�+� �� Z (please print) W Signature ,c)". Title Q i l.inti -- DOH-1555(oi/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# Town of Queensbury Certification of Cremation Pine View Cemetery and Crematory This certifies that the remains of: Edward L. Manney Jr. were cremated on October , 7 20 23 at the Pine View (Month) (Day) Crematorium, Queensbury,New York, and these are the cremated remains of said body. Date of Death October , a 20 23 Age 86 (Month) (Day) Funeral Home Singleton,Sullivan,Potter Funeral Home Registered No. 801 (Authorized Signature) BENTLEY - MANNEY Owner ,,, () Myrtle Bentley and Phyllis Manney --- Address Plot Hall Road R.D. #1 , Glens Falls, NY 12801 Single Interment Phone # Lot # 76 Sec. 2 Deed # Date 1865 �1, ;a7u.‘l -1-3-Iceq 7/3/1984 Cost Foundation Y - N 4pprax . .266 S.ix-Rrc.oZ. f , Location Bounded on North by Vacant, South by S. I. #1 , East by Vacant, West by Smith Remarks. �oia$S\Q She,RuxooD sa3- 4aq - (465L ` OS - 557a Record of Interments A) R. Wayne Bentley 8/14/95(j(t 6 Myrtle R. Bentley 7/20/85 1B) Chad Sherwood 1U/23/04 Crem '�7 a � 1 ' �� ; C\"lCtc:A - \ i.e_c_, > 1-1 , )5 1)_10 1 ,,; -' .) 1 1Coy. a3 4 �I,k 3 , fir►►, C� •-e 10. 1D a3 9 5 10 vAca,01- s V "' M ►, T C -r ti �` S b ,-1 w ,t > L X . ;r5 '6. LI `LI 5 1. a '3 Manney Jr. L( F).NAME Edward L. Manney Jr. ge: 86 Lot Owner: Myrtle Bentley & Phyllis Manney Lot# Single Interment #2 76 Grave# Case: urn Died: 1 0.4.2 3 Interred 1 0. 1 2.2 3 Funeral Home: Singleton Sullivan Potter Cemetery: Pine View