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Danahy, Diane Marie 1 NEW YORKSTATE DEPARTMENT OF HEALTH • Burial - Transit Permit Bureau of Vital Records \. 4: F Name First Middle Last Sex Diane Marie Danahy Female Date of Death Age If Veteran of U.S.Armed Forces, 01/24/2024 76 Years War or Dates ZPlace of Death Hospital,Institution or City,Town or Village Queensbury Town Street Address 12 Evanna Drive, Queensbury Town, New York 12804 pManner of Death ❑X Natural Cause Accident ❑Homicide ill Suicide Undetermined Pending V Circumstances Investigation IU Medical Certifier Name Title 0 Melanie Duerr NP Address 47 Tom Phelps Lane,Mineville Hamlet,New York 12996 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 19 Burial Date Cemetery,Crematory or Facility Name 01/26/2024 Pine View Crematory — _Entombment Address ©Cremation Queensbury,New York ElDonation 0❑Removal Date Place Removed and/or and/or Held N Hold Address Transportation Date Point of ffi Elby Common Shipment Carrier Destination Disinterment II 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 F. Remains are Shipped,If Other than Above 2 Address Q W d' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/26/2024 Registrar of Vital Statistics CaroCine7fi&(egarde Barber(E(ectronicallySigned) (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: H WDate of Disposition /-.�7-2G'Zy Place of Disposition /`iJ e t J et.c.J L r-e o �t 1.17 2 (address) ILLI Nre (section) (lot number) (grave number) GName of Sexton or Person in Charge of Prem. es ����' �� Z (please print) W Signature i. Prem. Are°' Title v el-4 g � �6 DOH-1555(07/18)p 1 of 2 s P 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#