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Towers, Ann E.
# Z, NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Ann E.Towers Female Date of Death Age If Veteran of U.S.Armed Forces, 02/26/2021 95 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Guilderland Town Street Address 23 Malpass Road,Guilderland Town,New York 12203 W Undetermined Pending W Manner of Death ©Natural Cause Accident Homicide Suicide El Circumstances Investigation W Medical Certifier Name Title O Adam Lammly DO Address 5 Palisades Dr,Albany,New York 12205 Death Certificate Filed District Number Register Number City,Town or Village Guilderland 0155 35 Burial Date Cemetery,Crematory or Facility Name 03/02/2021 Pine View Crematory Entombment Address 0 Cremation Queensbury Town,New York EiDonation Z ❑Removal Date Place Removed and/or and/or Held • Hold Address CA LiTransportation Date Point of Q by Common Shipment Carrier Destination Disinterment Date Cemetery Address El Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom �.. Remains are Shipped,If Other than Above g Address W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/02/2021 Registrar of Vital Statistics Lynne Buchanan(Electronically Signed) (signature) District Number 0155 Place Guilderland, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: IH WDate of Disposition 31 y� .N Place of Disposition d<� 2 (a dress) W cc N (pion) (lot number) ` (grave number) Name of Sexton or Person in Charge of P • es hs � .J w.44(0 (plea print) W Signature Title DOH-15551o7/18)p t of 2 Public Health Law Sec. 4145(2b) F 1 4 1-5 1. Receipt Human remains of delivered on , 20 , Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#