Ligamari, Letitia J. `17c
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Letitia J.Ligamari Female
Date of Death Age If Veteran of U.S.Armed Forces,
06/03/2021 93 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Granville Town Street Address Slate Valley Center for Rehabilitation and Nursing
p▪ Manner of Death Natural Cause Accident ElHomicide ❑Suicide ❑Undetermined EiPending
W Circumstances Investigation
W Medical Certifier Name Title
G Leonard Gelman MD
Address
10421 State Route 40,Granville Town,New York 12832
Death Certificate Filed District Number Register Number
City,Town or Village Granville 5756 47
ElBurial Date Cemetery,Crematory or Facility Name
06/07/2021 Pine View Crematory
Entombment Address
12 Cremation Queensbury,New York
Donation
go Removal Date Place Removed
and/or and/or Held
Hold Address
N
O
a Date Point of
(/a❑Transportation Shipment
O by Common
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
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
Cr
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 06/07/2021 Registrar of Vital Statistics Jenny Linea 94 Warte&(E(ectronica(Ty Signed)
(signature)
District Number 5756 Place Granville, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition (PI g(7( Place of Disposition ( r��l �r"'�oftw—
address)
CO (section) lot number) (grave number)
SName of Sexton or Person in Charge of Prem. s t d34,6ALS
(pleasee rint) .,��
W Signature Title l '�47) .
DOH-1555(07/18)p 1 of 2
1
Public Health Law Sec. 4145(2b) U 1' °8 4 2
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#