Loading...
Runnalls, Bruce David is-7 10F, NEW YORK STATE DEPARTMENT OF H EALTH Burial - Tra sit Permit Bureau of Vital Records n Name First Middle Last Sex Bruce David Runnalls Male Date of Death Age If Veteran of U.S.Armed Forces, 02/12/2024 69 Years War or Dates 1972-1974 1,,,,, Place of Death Hospital,Institution or City,Town or Village Fort Ann Town Street Address 26 Clay Hill Road, Fort Ann Town,New York 12827 a Manner of Death ❑^ Natural Cause Accident ii Homicide Suicide ❑Undetermined Pending Circumstances Investigation ILI Medical Certifier Name Title CI Curtis Gedney MD Address 454 Glen Street, Glens Falls,New York 12801 Death Certificate Filed Town Of Fort Ann District Number Register Number City,Town or Village 5754 2 Burial Date Cemetery,Crematory or Facility Name 02/13/2024 Pineview Crematorium Entombment Address ©Cremation Queensbury Town,New York ❑Donation ©EIRemoval Date Place Removed and/or and/or Held Hold Address E- Date Point of N Transportation by Common Shipment Carrier Destination Date Cemetery Address ❑Disinterment I Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Mason Funeral Home 01117 Address 18 George St Po Box 277, Fort Ann, New York 12827-0277 Name of Funeral Firm Making Disposition or to Whom .. Remains are Shipped,If Other than Above Address CC W >tL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/12/2024 Registrar of Vital Statistics Miranda Herringshaw(Electronically Signed) (signature) District Number 5754 Place Town Of Fort Ann I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: F= Date of Disposition 71 t3I71 Place of Disposition (-7114s5u GP6 MA TarU--.. Z, (address) W t (section) (lot number) � 'W (grave number) Name of Sexton or Person in Charge o ises ,r tt tease print) iLt Fe 414 IV Signature Title ln� DOH-1555(07/18)p 1 of 2 1 J - r Public Health Law Sec. 4145(2b) ; Receipt Human remains of delivered on , 20 I Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#