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Sheehan, Ronald J
IsNic.---. .- lcI NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Ronald J Sheehan Male Date of Death Age If Veteran of U.S.Armed Forces, 02/06/2024 83 Years War or Dates F.. Place of Death Hospital,Institution or W City,Town or Village Hadley Hamlet Street Address 2120 N Shore Road, Hadley Hamlet, New York 12835 p Manner of Death El Natural Cause Accident El Homicide OSuicide []Undetermined El Pending W Circumstances Investigation W Medical Certifier Name Title 0 Paul Gebhard MD Address 1 West Avenue,Saratoga Springs,New York 12866 Death Certificate Filed Town Of Hadley District Number Register Number City,Town or Village 4558 2 Burial Date Cemetery,Crematory or Facility Name 02/09/2024 Pineview Crematory Entombment — Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held F-N Hold Address 0 O. Date Point of UN❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above a Address CC W IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/09/2024 Registrar of Vital Statistics Colleen Demarsh(Electronically Signed (signature) District Number 4558 Place Town Of Hadley I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z W Date of Disposition 2 I Et)2H Place of Disposition 'r;,,ie-,/xeS.-1 (eF Me}IVellir—. 2 (address) Ili N EC (section) if (lot number (grave number) Name of Sexton or Person in Charge of remises f s 14 Zv/ease print) 46. . W Signature Title tr4c own' DOH-1555 l07/18)p 1 of 2 , j C.cat I' 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#