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Bellew, Marion Elizabeth NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Marion Elizabeth Bellew Female Date of Death Age If Veteran of U.S.Armed Forces, 11/21/2020 94 Years War or Dates F Place of Death Hospital,Institution or Z City,Town or Village Queensbury Town Street Address The Stanton Nursing And Rehabilitation Centre WI p Manner of Death © Natural Cause I:IAccident ❑Homicide I=1 Suicide 0 Undetermined ❑Pending W Circumstances Investigation W Medical Certifier Name Title a Wendy Steinhacker PA Address 152 Sherman Ave,Queensbury Town,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 5657 209 ©Burial Date Cemetery,Crematory or Facility Name 11/25/2020 Pine View Cemetery Entombment Address ElCremation Queensbury Town,New York 0 Donation Z ❑Removal Date Place Removed and/or and/or Held N Hold Address 2 Date Point of 0 Li Transportation Shipment 5 by Common Carrier Destination ID Disinterment Date Cemetery Address Date Cemetery Address Reinterment Permit Issued to Registration Number 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 F. Remains are Shipped,If Other than Above 2 Address Q W C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/23/2020 Registrar of Vital Statistics Caroline.Jfifiegarde Barber(E(ectronicalTySigned) (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: i_ VW Date of Disposition j l •ZS-ZAzo Place of Disposition `�/ �j.(G yj u), /`C� • ��A��� . t" w 2 kj �-� (address) / ud - li` or / / (lot number) (grave number) 8 Name of Sext. •or Person in Charge of Pr ises N l c L• 6-tp eel e z (pi eP(lnfl W Signature it L . ' f.- Titl e ‘" DOH-1555(07/18)p 1 of 2 Public Health Law Sec.4145(2b) 012822 Receipt it Human remains of ' • delivered on < , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# BELLEW NAME Marion Elizabeth Bellew Age: 94 Lot Owner: Donald H. & Marion E. Bellew Lot# New Hudson Lot #47Sec#3 Grave# 1 Case: Concrete Died: 1 1 /21 /2 0 2 0 Interred1 1 /2 5/2 0 2 0 Funeral Home: Regan Denny Staf ford Cemetery: Pine View