Loading...
Fessenden, Janet Alma NEW YORKSTATE DEPARTMENT OF HEALTH ' Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Janet Alma Fessenden Female Date of Death Age If Veteran of U.S.Armed Forces, 04/15/2020 89 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Glens Falls Street Address Glens Falls Hospital 13 Manner of Death ©Natural Cause Accident ❑Homicide Suicide Undetermined Pending V Circumstances Investigation Wtj Medical Certifier Name Title Stephen Perazzelli MD Address 100 Park St,Glens Falls, New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 177 ❑Burial Date TCemetery,Crematory or Facility Name 04/16/2020 Pine View Crematory Entombment Address ECremation Queensbury Town,New York ❑Donation zRemoval Date Place Removed and/or and/or Held H N Hold Address O IL Date Point of to ❑Transportation p by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls, New York 12803 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above 2 Address Q W d Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/16/2020 Registrar of Vital Statistics Robert Andrew Curtis(Electronically Signed) /signature/ District Number 5601 Place Glens Falls, 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 I Z(3 Place of Disposition L ao o, W /address) W N /section) /lot nu (grave number) 113 Name of Sexton or Person in Charge of Premises r' /p!e a print/Z W Signature Title ` DO H-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 0 1. "5 5 4 Receipt Human remains of delivered on , 20 j Pine View Cemetery — Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#