Akers, Stanley D. 4—MOZ_
NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Stanley D.Akers Male
Date of Death Age If Veteran of U.S.Armed Forces,
10/24/2020 83 Years War or Dates 1956-1958
l— Place of Death Hospital,Institution or
W City,Town or Village Wilton Town Street Address 629 Maple Avenue,Wilton Town,New York 12866
p Manner of Death ❑X Natural Cause 0 Accident ❑Homicide ❑Suicide ❑Undetermined El Pending
W C.) Circumstances Investigation
W Medical Certifier Name Title
O Eugene Ladue Coroner
Address
31 Woodlawn Ave.,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Gansevoort 4569 46
❑Burial Date Cemetery,Crematory or Facility Name
10/27/2020 Pine View Crematory
❑Entombment Address
0 Cremation Queensbury Town,New York
❑Donation
ZO 0 Removal Date Place Removed
- and/or and/or Held
~- Hold Address
N
0
d Date Point of
Cl) Li Transportation
Q by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Date Cemetery Address
❑Reinterment
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
1 Remains are Shipped,If Other than Above
Address
CC
W
0-
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/27/2020 Registrar of Vital Statistics Susan Baldwin(Electranical5,Swned)
(signature)
District Number 4569 Place Gansevoort, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H itoZ Date of Disposition /0)41k Place of Disposition ci�
2 (address)
W
NCC (section) (lot number (grave number)
0▪ Name of Sexton or Person in Charge of Premi es C "� � �^�
(plef seprint) ft
` y�,,�
441
IllSignature 4 Title ` '� "i
DOH-1555(o7/t8)p 1 of 2
Public Health Law Sec. 4145(2b) 01" - 2
Receipt
Human remains of / r r delivered on , 20
Pine View Cemetery Representing the funeral home namecon burial permit
Official Funeral Directors Reg.or License#