Ovitt, William TOTtiN OF QUEE BU
-r�y
PINE VIEW CEMETERY AND CREMATORIUM
QUAKER ROAD, QUEENSBURY, NEW YORK 12804
(518) 745-4476 (518) 745-4-477
/ Funeral Director
/ J�
ale 41.,/i/� ��/J,1 (�1/i Casea
_ate Of Cremation
T =me Cremation Started
me Cremation Completed 3 e� "� •�
e of Container A���
�e^�arks �=:
1 ,12, t I'?AA
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DISPOSITION OF CREMATED REMAINS
I hereby direct Pine View Crematorium to dispose of the cremated remains as follows:
Mail to
Other arrangemer.is-p;---ase specify: Return to Funeral Director
If pulverization of cremated remains is requested, check here XX
POLICIES, RULESAND REGULATIONS
1. The crematorium 1..:ll t)e open for cremations 5 days a week 7:00 A.M. - 3:30 P.M. Monda,
Friday. No Helida;5 or..Sundays, arrangements can be made for Saturday. Prearrangeme-r-
by telephone for acceptance of remains is necessary.`
2. Pine View Crematorium is located on the grounds of the Pine View Cemetery, Quaker Roy:
Town of QueE isb:::y
3. An authorization for cremation properly signed by the nearest next of kin or other authorize::
person stating that they do have the power and authority to arrange for the cremation of the.
remains and to dire: t the disposition of the cremated remains, that any personal possessic7.
have either been r, noved or.may be destroyed.and.agree to protect, defend and save
harmless Pine Vie:, Crematorium from any and all claims and demands for loss or damages
which may be macro against them by reason of or connected with the cremation of said
remains and /or disposition of said remeins,as.directed,whether such claims or demands ; r
or are not wholly groundless, false or fraudulent. This authorization in addition to a regular
burial permit must accompany the remains.
4 All remains must t:: encased in a casket or suitable alternate container. Caskets and
containers must be of combustible material. No Styrofoam or plastic containers will be
accepted.
5. The question relative to cardiac pacemakers must be answered on the authorization to
cremate form befc, the remains will be accepted.
6. Unless other arrangements are made the cremated remains will be mailed via Registered
U.S. Mail within three daystf-crematidn to'the funeral home handling the service. There v.
be a $20.00 chargf: forthis'service.
Cremation, Administration Costs and Recording Fee: Adult$225.00 Children (age 13 months
12 years) $115.00 Infants (stillborn to 12'months)$75.00
' Additional $50.00 charge for cremations done after 3:00 P.M. Monday through Friday.
Cremations done on Saturdays will be charged the additional$50.00.
TOWN OF QUEENSBURY
PINAE�sVrIEW CEMETERY
CREMATORIUM
Quaker Road, Queensbury, New York 12804
Phone(518) CrerQat9riumJ45-4477;(if no answer)
Cemetery 745-4476
AUTHORIZATION TO CREMATE
The undersigned requests and authorizes Pine View Crematorium, in accordance with and subject
to its Rules and Regulations to cremate the remains of:
William F. Ovitt Male
(NAME) Ot*4cw0 nuy.47 (SEX)
(�57 Schroon River Road, New York 1,1&&5
12 ?4
(STREET) (CITY) (STATE) (ZIP CODE)
who died on the a 314 day of ,X/ 200L
at ./#Owc
(PLACE (ADDRESS)
Name and address of nearest living relative:or name of person authorizing cremation:
Relationship to deceased ,•;,.- •hJ i
Name of Funeral Home Alexander Funeral Home, Inc.
IMPORTANT
I represent that to the best of.my:knowledge, the deceased.has or has no pacemaker in his or he
body. (CIRCLE ONE)
I certify;that I have:the,full;Rpyyq and,au ofj�atign.toae��ogg,9.-9,rjhe.cremation of the remains and
to direct the disposition;pf t r rmete.G r in ith Z4-ny4p#�p,paI:possessions have either been
removed or may be destroyed, and agree to protect, defer o,nd"tsave:harmless Pine View
Crematorium from any and all claims and demands for loss or damages which may be made
ag them by reason of or.connected with the,cremation of said remains as directed, whether
sic claims or demands are or are not wholly groundless, false or fraudulent.
John S. Alexander — 3809 Main St. , Warrensburg, NY 12885
(WITNES ) (ADDRESS)
illia�FOvitt — Schroon River Rd. rgNY 12891
(SIGNATURE OF RELATIVOR LEGAL REP. AND ADDRESS)
Signed on this date: May 15, 2001