Zarro, Tammy Lyn NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Tammy Lyn Zarro Female
Date of Death Age If Veteran of U.S.Armed Forces,
12/23/2021 54 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address 9 Murdock Avenue,Glens Falls, New York 12801
IJJ
p Manner of Death ❑X Natural Cause Accident ❑Homicide El Suicide El Undetermined ❑Pending
U Circumstances Investigation
ILI Medical Certifier Name Title
C Connie Goedert Coroner
Address
1400 St Route 9,Lake George Town,New York 12845
Death Certificate Filed District Number Register Number
City,Town or Village Glens Falls 5601 634
❑Burial Date Cemetery,Crematory or Facility Name
12/28/2021 Pine View Crematory
❑Entombment Address
0 Cremation Queensbury Town,New York
❑Donation
Z Removal Date Place Removed
and/or and/or Held
Hold Address
CO
O
0. Date Point of
CO ❑Transportation Shipment
p by Common
Carrier Destination
❑Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
F- Remains are Shipped,If Other than Above
2 Address
CC
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/28/2021 Registrar of Vital Statistics *Idert/?nrlrew Curtis(ElectronicallySrgnet9
(signature)
District Number 5601 Place Glens Falls, 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 -2U.Z/ Place of Disposition ,j(? �j Cr 440.1
W (address/
ILI
N a (section) (lot number) (grave number)
gName of Sexton or Person in Charge f Pre ise Ida /311),'1 �opci
UJ
� (please print)
Signature Title De w 11��
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b)
01 4 h
Receipt
Human remains of delivered on , , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# '