McCarty, Joyce .,: it 2 ,
NEW YORK STATE DEPARTMENT OF HEALTH,Vital Records Section Burial - Transit Permit
' Name First Middle Last Sex
Joyce I McCarty Female
Date of Death Age If Veteran of U.S. Armed Forces,
'1 04/03/2018 88 Years War or Dates
• Place of Death Hospital, Institution or
CitU.Iy, Town or Village Granville Town Street Address The Orchard Nursing And Rehabilitation Centre
p Manner of Death a Natural Cause 0 Accident 0 Homicide 0 Suicide riUndetermined El Pending
VCircumstances Investigation
W Medical Certifier Name Title
Carl Beckler MD
Address
10421 State Route 40,Granville Town,New York 12832
::, Death Certificate Filed District Number Register Number
City, Town or Village Granville 5756 7
❑Burial Date Cemetery or Crematory
04/05/2018 Pine View Crematory
El Entombment Address
®Cremation Queensbury, New York
,- Date 'lace Removed
❑Removal 'nd/or Held
and/or Address
w Hold
0 Date Point of
❑Transportation Shipment
i 3 by Common Destination
Carrier
❑Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
• Permit Issued to Registration Number
;s 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
Remains are Shipped, If Other than Above
a Address
W
-,' Permission is hereby granted to dispose of the human remains described above as indicated.
• Date Issued 04/04/2018 Registrar of Vital Statistics Julia Goff(ECectronicaCCySigned)
(signature)
District Number 5756 Place Granville, New York
I certify that the remains of the decedent identified above were disposed ofI in accordanceA with this permit on:
p y/1 lig DispositionT v V /,
W Date of Disposition Place of , � or-
2 (address)
W
O (section) J(lot number) (- (grave number)
p Name of Sexton or Person in Charge of Premises /1,. �p4-- ✓.•`#t
(phase print)
W Signature �'� Title Moilfp-
(over)
DOH-1555 (02/2004)