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Huffer, Judith Ann
NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Judith Ann Huffer Female Date of Death Age If Veteran of U.S.Armed Forces, 01/13/2021 74 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Tupper Lake Town Street Address Mercy Living Center p Manner of Death © Natural Cause ❑Accident 1=1 Homicide Suicide Undetermined Pending W Circumstances Investigation W Medical Certifier Name Title O Mario Tagliagambe MD Address 114 Wawbeek Ave,Tupper Lake Town, New York 12986 Death Certificate Filed District Number Register Number City,Town or Village Tupper Lake 1650 2 Burial Date Cemetery,Crematory or Facility Name 01/14/2021 Pine View Crematory ElEntombment Address ElCremation Queensbury Town,New York ❑Donation Z• Removal Date Place Removed and/or and/or Held N. Hold Address 0' d Date Point of (/) ❑Transportation Shipment p by Common Carrier Destination El Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Argyle 01077 Address 123 Main St,Argyle,New York 12809 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above a Address LC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/14/2021 Registrar of Vital Statistics Laurie J cFu[Cer(ECectronically Signed) (signature) District Number 1650 Place Tupper Lake, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition (/ ( Place of Disposition � L 2 (address) W O (section) /,(lot number) �� (grave number) Name of Sexton or Person in Charge Premises Z (ple a print) W Signature Title CnkAtocpC DOH-1555(o7/18)p t of 2 Public Health Law Sec. 4145(2b) 014416 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#