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Morehouse, Betty Jean Emma
>z1 Eft NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Betty Jean Emma Morehouse Female Date of Death Age If Veteran of U.S.Armed Forces, 06/22/2021 91 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Horicon Town Street Address 6676 State Rt 8,Horicon Town,New York 12815 pManner of Death ©Natural Cause El Accident 0 Homicide Suicide El Undetermined El Pending Circumstances Investigation W Medical Certifier Name Title CI Kate Sauer-Jones PA Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Brant Lake 5654 4 ElBurial Date Cemetery,Crematory or Facility Name 06/23/2021 Pine View Crematorium IDEntombment Address ©Cremation Queensbury Hamlet,New York EiDonation 60 Removal Date Place Removed and/or and/or Held H Hold Address 0 O. Date Point of 0 �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 E.. Remains are Shipped,If Other than Above 2 Address W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/23/2021 Registrar of Vital Statistics Vista G Wool(E(ectronicalTySigned) (signature) District Number 5654 Place Brant Lake, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ZtU Date of Disposition %a.c,,?-j Place of Disposition p V tc..,/ C.r�Si-arY (address) W CC (section) (lot number) (grave number) 8 Name of Sexton or Person in Charge of Premises Z (please print) W Signature 34 Title C,re DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) ' 14 8 8 7 Receipt Human remains of ; j delivered on • , 20 ' Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#