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Granger,Oliva Margaret 1-1 NEW NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Olivia Margaret Granger Female Date of Death Age If Veteran of U.S.Armed Forces, 02/23/2021 69 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ©Natural Cause Accident Homicide ❑Suicide ❑Undetermined ❑Pending lL Circumstances Investigation U W Medical Certifier Name Title O David Foote MD Address 340A Main Street,Hudson Falls Village,New York 12839 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 114 ElBurial Date Cemetery,Crematory or Facility Name 02/25/2021 Pine View Crematorium Entombment Address 0 Cremation Queensbury Town,New York EIDonation 8 Removal Date Place Removed and/or and/or Held F Hold Address N 0 d. Date Point of Cl) Li Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above g Address CC Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/25/2021 Registrar of Vital Statistics W96ertAndrew Curtis(ECectronicalry Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: eft, ��WDate of Disposition Z/24121 Place of Dispositiont„� r.� 2 (a dress) ILI CC (section) (lot number) (grave number) CCS 0 Name of Sexton or Person in Charge of P mises /hcc .._ `� t ►i l tr Z (plea print) Signature Title Ax44 DOH-1555(07/18)p 1 of 2 . y Public Health Law Sec. 4145(2b) d i. 4 5 8 Receipt Human remains of delivered on _ , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#