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Schraver Jr, Steven M. ,I/ NEWYORK STATE DEPARTMENT OF-HEALTH Buriai - Transit Permit Bureau of Vital Records Name First Middle Last Sex Steven M Schraver Jr Male Date of Death Age If Veteran of U.S.Armed Forces, 01/22/2020 25 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Corinth Town Street Address 4860 State Route 9N, Corinth Town, New York 12822 LU p Manner of Death Natural Cause Accident Homicide ©Suicide ❑Undetermined Pending tL Circumstances Investigation U W Medical Certifier Name Title 0 David DeCelle Coroner Address 40 McMaster Street,Ballston Spa, New York 12020 Death Certificate Filed District Number Register Number City,Town or Village Corinth ---74553 4 ❑Burial Date Cemetery,Crematory or Facility Name 01/27/2020 Pine View Crematory Entombment Address RI Cremation Queensbury Town,New York Donation OZ Removal Date Place Removed FI and/or and/or Held F- Hold Address N 0 C. Date Point of (A Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 Address 24 Church Street PO Box 500, Lake Luzerne,New York 12846 Name of Funeral Firm Making Disposition orto Whom F Remains are Shipped,If Other than Above Address W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/27/2020 Registrar of Vital Statistics Rose E Farr(Electronically Signed) (signature) District Number 4553 Place Corinth, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H Z Date of Disposition /-Z 7-W 70 Place of Disposition LU (addr s) W N (section) (lot number) (grave number) 0 Name of Sexton or Perso a IV in Char a of Premises ��l��`� "'�` e z W Title (please print/ / Signature DOH-1555(07/18)pi of 2 Public Health Law Sec. 4145(2b) 013279 Receipt Human remains of delivered on , 20 Zfj t A4 Pine View Cemetery Representing th funeral hom named n burial permit Official Funeral Directors Reg.or License# � O i i i