Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Lapier, Beverly A
ft NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Beverly A Lapier Female Date of Death Age If Veteran of U.S.Armed Forces, 11/10/2021 81 Years War or Dates F.. Place of Death Hospital,Institution or WCity,Town or Village Hadley Town Street Address 75 First Avenue,Hadley Town,New York 12835 p Manner of Death ©Natural Cause El Accident El Homicide ❑Suicide ❑Undetermined El Pending W C.) Circumstances Investigation WQ Medical Certifier Name Title George Siniapkin MD Address 604 Palmer Avenue,Corinth Town,New York 12822 Death Certificate Filed District Number Register Number City,Town or Village Hadley 4558 22 Burial Date Cemetery,Crematory or Facility Name 11/13/2021 Pineview Crematory EI Entombment Address EiCremation Queensbury Town,New York EiDonation 8 Removal Date Place Removed and/or and/or Held F-N Hold Address O Q. Date Point of N ❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom F Remains are Shipped,If Other than Above g Address Cr W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 11/12/2021 Registrar of Vital Statistics Pauline G Smead(Electronically Signed) (signature) District Number 4558 Place Hadley, 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 j�/3 j.,‘'2/ Place of Disposition j j e \JI ')e Cf' �Yi/y r (address) W N (section),—j� J /(lot n ber) (grave number) • Name of Sexton or Person in Charge f Premises ► 4 plipi vC' IY 01>j z (please print) W Signature Z i Title O YL r DOH-1555(07/18)p t of 2 Public Health Law Sec. 4145(2b) Receipt • Human remains of ` 'r' ' `- delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#