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McCarty, MaryAnne NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex MaryAnne McCarty Female Date of Death Age If Veteran of U.S.Armed Forces, 12/23/2021 61 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Argyle Town Street Address Washington Center For Rehabilitation And Healthcare 0 Manner of Death ©Natural Cause ❑Accident El Homicide ID Suicide ❑Undetermined ❑Pending VCircumstances Investigation WG Medical Certifier Name Title Brandii Baker NP Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Argyle 5750 81 — 0 Burial Date Cemetery,Crematory or Facility Name 12/28/2021 Pine View Crematory ❑Entombment Address — X❑Cremation Queensbury Town,New York ❑Donation C ❑Removal Date Place Removed and/or and/or Held F Hold Address CA fA ❑Transportation Date Point of 3 by Common Shipment Carrier Destination 11 Disinterment Date Cemetery Address Reinterment 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 H. Remains are Shipped,If Other than Above a Address Q 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 S/iel(ey Mckernon(E(ectronica1TySigned) /signature/ District Number 5750 Place Argyle, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition UJ �`;� 1/ Place of Disposition t\)o d; e,,,d C 1—e4vi 4 p4-4 2 (address) W CO (section) (lot numbf rJ (grave number) 8 Name of Sexton or Person in Charge of Premises F /l4'i C.)•7 j (4P o"Ci z (please print) W Signature /�'" '' f Title (,/Ke41 i'1Y-. DOH-1555(07/18)p 1 of 2 l r.. .• Public Health Law Sec. 4145(2b) IReceipt 1 Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#