Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Bartlett, Linda Lee
5�3 NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Linda Lee Bartlett Female Date of Death Age If Veteran of U.S.Armed Forces, 05/10/2020 69 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Queensbury Town Street Address 36 Country Colony Road,Queensbury Town,New York 12804 Mannerof Death ©Natural Cause Accident ❑Homicide ❑Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title John Stoutenburg MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 5657 100 Burial Date Cemetery",Crematory or Facility Name 05/12/2020 Pine View Crematory Entombment Address Cremation Queensbury Town,New York Donation Removal Date Place Removed and/or and/or Held F Hold Address M ❑Transportation Date Point of by Common Shipment Carrier Destination Disinterment Date Cemetery Address 2�„ Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/11/2020 Registrar of Vital Statistics CaroCine 9fiCdegarde Barber(ECectronically Signed) (signature) District Number 5657 Place Queensbury, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 5 1 i9170 Place of Disposition ZL 61t� (address) (sedan) (lot number) (grave number) Name of Sexton or Person in Charge of Tises (pleas print) Signature Title ` DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) - - - . 13 751, Receipt Human remains of i - delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#