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McCarty, David W low NEW YORK STATE DEPARTMENT OF HEALTH ii Bureau of Vital Records Burial - Transi t er It Name First Middle Last Sex David W.McCarty Male Date of Death Age If Veteran of U.S.Armed Forces, 02/18/2024 86 Years War or Dates i— Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital UJ O Manner of Death ZI Natural Cause Accident ❑Homicide 0Suicide Undetermined Pending UJ Circumstances Investigation W Medical Certifier Name Title O Scott Biasetti MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 102 RBurial Date Cemetery,Crematory or Facility Name 02/21/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held pNQ Hold Address Date Point of N ETransportation Shipment s by Common Carrier Destination O Disinterment Date Cemetery Address El 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 -. Remains are Shipped,If Other than Above `a Address R W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/21/2024 Registrar of Vital Statistics Megan Nofin(E(ectronicalfy 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: I— Z Date of Disposition 2I Z.Z.I2a Place of Disposition ytiCt i) irrAOltj1r 2 (address) W NCC (section) (lot number) (grave number) gName of Sexton or Person in Charge of Premises • 7If' ���f tt Z (lase print) W Signature Lf Title APE MAW DOH-1555(o7/18)p 1 of 2 !''. 'wl 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#