Lamica, Linda NEWYORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Linda Lamica Female
Date of Death Age If Veteran of U.S.Armed Forces,
04/30/2020 66 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Valatie Village Street Address Barnwell Nursing And Rehabilitation Center
W Manner of Death a Natural Cause Accident Homicide 1:1Suicide Undetermined Pending
V Circumstances Investigation
W Medical Certifier Name Title
Kathleen Steiger NP
Address
3230 Church St,Valatie Village,New York 12184
Death Certificate Filed District Number Register Number
City,Town or Village Valatie Village 1023 23
❑Burial Date Cemetery,Crematory or Facility Name
05/04/2020 Pine View Crematory
Entombment Address
X Cremation Town of Queensbury,New York
❑Donation
CRemoval Date Place Removed
and/or and/or Held
H N Hold Address
O
d. Date Point of
CO) ❑Transportation
G by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
IFI Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
I— Remains are Shipped,If Otherthan Above
Address
W
IL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 05/04/2020 Registrar of Vital Statistics Badarafnn Tuafrer(E&tronica*Srgned)
(signature)
District Number 1023 Place Valatie Village, 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 Place of DispositionQ (
W
2 (addre )
W
(section) /lot number/ (grave number)
8 Name of Sexton or Person in f Pre ises !�L` �n C (PleaseC.
Z
W
Signature Title
DOH-i555(07/18)p t of 2
r.,.,rrr
Public Health Law Sec. 4145(2b) 01�6 S
Receipt
jHuman remains of delivered on , 20_
1
1
1
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#