Vadnais, Janice Elaine NEW YORK STATE DEPARTMENT OF HEALTH l"."CF)" Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
_Janice Elaine Vadnais Female
Date of Death Age If Veteran of U.S.Armed Forces,
05/10/2022 71 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address 390 Church Street,Saratoga Springs,New York 12866
W Manner of Death
W Ei Natural Cause Accident �Homicide OSuicide Undetermined ri Pending
Circumstances Investigation
W Medical Certifier Name Title
CI Mirabelle Beck NP
Address
394-402 Church Street,Saratoga Springs,New York 12866
Death Certificate Filed City Of Saratoga Springs District Number Register Number
City,Town or Village 4501 300
X Burial Date Cemetery,Crematory or Facility Name
05/13/2022 Pine View Cemetery
_Entombment Address
Cremation Queensbury,New York
Donation
O Removal Date Place Removed
and/or and/or Held
H Hold Address
N
0
Date Point of
Cl)❑Transportation
CI by Common Shipment
Carrier Destination
111
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
F Remains are Shipped,If Other than Above
Address
Q
W"
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 05/12/2022 Registrar of Vital Statistics 'DiQon Moran(E(ectronica1TySigned)
(signature)
District Number 4501 Place City Of Saratoga Springs
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
IH
Z▪ Date of Disposition Place of Disposition
(address)
W
CC (section) (lot number) (grave number)
0 Name of Sexton or Person in Charge of Premises
Z (please print)
W Signature Title
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b)
012913
Receipt
Human remains of- delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# 1
VADNAIS (IF)
NAME Janice Elaine Vadnais Age: 71 '
Lot Owner: Larry & Janice Vadnais
Lot# Erie 1 4 C Grave# 2
Case: Concrete
Died: 5/1 0/22 Interred: 5/1 3/22
Funeral Home: Regan Denny Staf ford
Cemetery: Pine View
VADNAIS
Owner
Larry & Janice Vadnais
Address Plot
44 Maple Drive Queensbury, NY 12804 Erie
Phone # Lot #
518-798-1464 14-C
Deed # Date
4088 9/20/2018
Cost Foundation Y - N
2400
Location
Bounded to the West by Vacant, North by Vacant
East by Romer, South by Fiore
Remarks
Record of Interments
1 6
Dom, 5. to.as 7
2 Acir,cce noi 5 S• 13 •070)
3 8
4 9
5 10
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