Hunt, Marie NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
4s Marie A.Hunt Female
°' D• ate of Death Age If Veteran of U.S. Armed Forces,
01 10/02/2017 65 Years War or Dates
Place of Death Hospital, Institution or
• City, Town or Village Lake Katrine Hamlet Street Address Northeast Center For Special Care
• Manner of Death®Natural Cause 0 Accident 0 Homicide El Suicide nUndetermined �Pending
Circumstances Investigation
'' Medical Certifier Name Title
Steven Ritter MD
Address tti •
• 300 Grant Ave,Lake Katrine Hamlet,New York 12449 7 ,
ig Death Certificate Filed District Number Register Nu , d
ri City, Town or Village Lake Katrine 5567 132 -,it) ,•;:
❑Burial Date Cemetery or Crematory ,rir
❑ 10/05/2017 Pine View Crematorium
Entombment --
�r. Address
®Cremation Queensbury Hamlet, New York
P. Date Place Removed
Removal and/or Held
and/or Address
Hold
Date Point of
Q Transportation Shipment
by Common Destination
Carrier
„t Date Cemetery Address
❑Disinterment
Renterment
Date Cemetery Address
iti
• Permit Issued to Registration Number
N• ame of Funeral Home Barton-Mcdermott Funeral Home Inc 00141
re Address
It 9 Pine St,Chestertown,New York 12817
Name of Funeral Firm Making Disposition or to Whom
R• emains are Shipped, If Other than Above
Address
VT
• Permission is hereby granted to dispose of the human remains described above as indicated.
iv
a Date Issued 10/04/2017 Registrar of Vital Statistics suZanneLouise wy 'Efectronuaffysigned
(signature)
v, a District Number 5567 Place Lake Katrine, New York
w4°
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition /O.-c /7 Place of Disposition ?i>i4-0 r .) Gre-
¢' (address)
(section) (lot number) (grave number)
N• ame of Sexton or e ' Charge of Premises Jt„.1 t a..'2 oa_erzo.,�-
4,, (please print)
Title e,—mini..,/✓--
(over)
DOH-1555 (02/2004)