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Hunt, Dorothy B
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Dorothy B.Hunt Female Date of Death Age If Veteran of U.S.Armed Forces, 09/08/2021 91 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Queensbury Town Street Address 34 Reardon Avenue,Queensbury Town,New York 12804 US j Manner of Death © Natural Cause EIAccident ❑Homicide EiSuicide 0 Undetermined 0 Pending 0' Circumstances Investigation Ui Medical Certifier Name Title John Sawyer MD Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village Queensbury 1 5657 187 ElBurial Date Cemetery,Crematory or Facility Name 09/09/2021 Pineview Crematorium ElEntombment Address 0 Cremation Queensbury Town,New York Donation Z❑Removal Date Place Removed and/or and/or Held Hold Address C*❑Transportation Date Point of by Common Shipment Carrier Destination E Disinterment Date Cemetery Address Date Cemetery Address ❑Reinterment Permit Issued to Registration Number Name of Funeral Home Mason Funeral Home 01117 Address 18 George St Po Box 277,Fort Ann,New York 12827-0277 Name of Funeral Firm Making Disposition or to Whom I..- Remains are Shipped,If Other than Above XAddress CC IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/09/2021 Registrar of Vital Statistics Caroline Hildegarde Barber(Electronically Signed) (signature) District Number 5657 Place Queensbury, New York - I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ' q`U— Date of Disposition I i0(1( Place of Disposition (address) 771.4*--- 2 iit 1 (sec/on) A (,lo number) (grave number) Name of Sexton or Person in Charge Premises r� l• ,,tt`i t /plea print) / Olt Lai "'TT V Signature Title ` DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 0.1 -.1.,`„ 'cd„, 5 1 Receipt 1 ? / ) Human remains of - 7 / 7/4/ r delivered on ; / - , 20 -3;) i ., /' Pine View View Cemetery Representing the funeral home named,oy,hybiApeymit Official Funeral Directors Reg.or License# / '4/'''((•r 1