Loading...
Zehnter, Kristin �NEW YORKSTATE DEPARTMENT OF HEALTH 3� Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Kristin E.Zehnter Female Date of Death Age If Veteran of U.S.Armed Forces, 04/12/2020 51 Years War or Dates IF- Place of Death Hospital,Institution or WCity,Town or Village Lake Luzerne Hamlet Street Address 300 Gailey Hill Road,Lake Luzerne Hamlet,New York 12846 p Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending VCircumstances Investigation GMedical Certifier Name Title David Cunningham MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Lake Luzerne 5656 g Burial Date Cemetery,Crematory or Facility Name 04/13/2020 Pine View Crematory Entombment Address 0 Cremation Queensbury Town, New York ❑Donation 0 Removal Date Place Removed and/or and/or Held ~ Hold Address N O I- Date Point of (A FiTransportation p by Common Shipment 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 Remains are Shipped,If Other than Above Address Q W C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/13/2020 Registrar of Vital Statistics Cynthia Sherwood(Electronically Signed) (signature/ District Number 5656 Place Lake Luzerne, 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 W Place of Disposition 2 (address) W tl9 Ir (section) (lot number) (grave number) 0 Name of Sexton or Person in Charge o emises Z (ple a print W Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 91353 5 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#