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Meyer, Emma May
361 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records • Name First Middle Last Sex Emma May Meyer Female Date of Death Age If Veteran of U.S.Armed Forces, 03/25/2021 76 Years War or Dates �:. Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital `p Manner of Death ©Natural Cause Accident ID Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title 0 Christopher Hoy MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 158 Burial Date Cemetery,Crematory or Facility Name 03/26/2021 Pine View Crematorium Entombment Address Cremation Queensbury Hamlet,New York EjDonation Z 0 Removal Date Place Removed and/or and/or Held }- Hold Address (/) 0 O. Date Point of W ❑Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Barton-Mcdermott Funeral Home Inc 00141 Address 9 Pine St,Chestertown,New York 12817 Name of Funeral Firm Making Disposition or to Whom i... Remains are Shipped,If Other than Above 2 Address CC W U. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/26/2021 Registrar of Vital Statistics 2igbert Andrew Curtis(ECecttonicallySigned) (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: Date of Disposition Place of Disposition (address) W (section) (lot number) (grave number) Name of Sexton or Person in Charge of Premises Z (please print) W Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 1 4673 Receipt Human remains of • , , delivered on ,' c • ;;20 / • - Pine View Cemetery Representing the funecal home named on burial permit Official Funeral Directors Reg.or License# *,