Steves, Christopher NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section % Burial - Transit Permit
Name First Middle Last Sex
Christopher J. Steves Male
Date of Death Ape If Veteran of U.S.Armed Forces,
May 26,2006 38 War or Dates
H Place of Death City of Glens Falls Hospital, Institution or 20 Knight Street
z City, Town or Village Street Address
W
3 Manner of Death x Natural Cause ❑ Accident ❑ Homicide ❑ Suicide ❑ Undetermined ❑ Pending
X Circumstances Investigation
UJ
0 Medical Certifier Name Title
G' Gary Scidmore,Coroner
Address
Brant Lake,NY
Death Certificate Filed District Number Register Number
City, Town or Village Glens Falls,NY 5601 v‘2/0
El Burial Date Cemetery or Crematory
May 30,2006 Pine View Crematory
❑ Entombment Address
XX Cremation Queensbury,NY
Date Place Removed
Z ❑ Removal and/or Held
O and/or Address
H Hold
N Date Point of
a ❑ Transportation Shipment
N by Common Destination
a Carrier
Date Cemetery Address
❑ Disinterment
Date Cemetery Address
❑ Reinterment
Permit Issued to Registration Number
Name of Funeral Home Singleton-Healy Funeral Home 01682
Address
407 Bay Road,Queensbury,NY 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
r
aPermission is hereby qra ted to dispose of the human remains descri d abov as' icat
Date Issued Ob ,.Q MC Registrar of Vital Statistics f.
tom
(signature)
District Number 5601 Place Glens Falls,NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
tZ Date of Disposition ���-6G_, Place of Disposition / C 71l E. G'i �- ( .1 -tl t eel 1 rc i 0 r-
LU (address)
W
to (se tion) (lot number) t(grave number)
fe
O Name of Sexton or Person in Charge of Premises (r�LZ L-{' re /r-- l-� N
(please print) \ _
W Signature 0�{'/ O ( ,; Title �- 6�r= �l '( ) C fZ
DOH-1555(02/2004) (over)