Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Colomb, Bonnie Rose
11 5r36 NEW YORK STATE DEPARTMENT OF HEALTH 1 Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Bonnie Rose Colomb Female Date of Death Age If Veteran of U.S.Armed Forces, 06/30/2021 83 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Lake George Town Street Address 38 Sagamore Street,Lake George Town,New York 12845-0791 W Manner of Death Pending � ©Natural Cause Accident �Homicide �Suicide �Undetermined � W Circumstances Investigation W Medical Certifier Name Title a Michael Bell MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Lake George 5651 12 ElBurial Date Cemetery,Crematory or Facility Name 07/01/2021 Pine View Crematory ElEntombment Address lCremation Queensbury,New York ElDonation ZO Removal Date Place Removed and/or and/or Held Hold Address N O d Date Point of j Transportation Shipment O by Common Carrier Destination Disinterment Date Cemetery Address EjReinterment 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 1— Remains are Shipped,If Other than Above " Address C W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/01/2021 Registrar of Vital Statistics Patricia R,McY(fnney-Schuster(ECectronica1tYSigned) (signature) District Number 5651 Place Lake George, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 7-2.-sue;-f Place of Disposition rk,` \j;Cu) Vrtiw e Y LLI 2 (a dress) W CC (section) (lot number) (grave number) 8 Name of Sexton or P rso in Charge of Premises J.V1i+z.Y Sty C (please print) W Signature Title red"A SC DOH-1555(07/18)p 1 of 2 I Public Health Law Sec. 4145(2b) 0 1 el S s,r,s,. Receipt Human remains of ' delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#