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Posteraro, Sandra ` I It.C NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Sandra Posteraro Female Date of Death Age If Veteran of U.S. Armed Forces, July 24,2013 66 War or Dates . Place of Death Hospital, Institution or fZ City, Town or Village Bolton Street Address 37 Horicon Avenue US Manner of Death I R�Natural Cause Accident Homicide Suicide Undetermined Pending titCircumstances Investigation tii Medical Certifier Name Title 0: Suzanne Bergin Address ;._-3767 Main Street,Warrensburg,NY 12885 ; Death Certificate Filed District Number Register,Number F_ City, Town or Village Bolton 5650 of ❑Burial Date Cemetery or Crematory Entombment July 25,2013 Pine View Crematory Address ©Cremation 21 Quaker Rd., Queensbury, NY 12804 Date Place Removed Z I I Removal and/or Held O and/or Address E' Hold N O Date Point of N I I Transportation Shipment p by Common Destination Carrier Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander-Baker Funeral Home 00037 Address • 3809 Main Street,Warrensburg,NY 12885 Name of Funeral Firm Making Disposition or to Whom 1. Remains are Shipped, If Other than Above 'N: Address tli Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 7- 2 5— )3 Registrar of Vital Statistics 0h4, , (signaturd) District Number 5650 Place Bolton I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z W � l /� Date of Disposition '1-l�.,t'3 Place of Disposition R...IL ers.0411.- W (address) co ce (section) g (lot number) (grave number) p Name of Sexton or Person in Charge of Premi s ,, 64 W (pleese print) Signature Title ClYit (over) DOH-1555 (02/2004)