Loading...
Woodell, Steven M e1 ..g.-Z NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit - Bureau of Vital Records Name First Middle Last Sex Steven M.Wooddell Male Date of Death Age If Veteran of U.S.Armed Forces, 05/04/2022 46 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital WManner of Death (� Undetermined Pending © a Natural Cause Accident I I Homicide Suicide W U Circumstances Investigation ILIQ Medical Certifier Name Title William Cleaver MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 , 249 Burial Date Cemetery,Crematory or Facility Name 05/09/2022 Pineview Crematorium Entombment Address ECremation Queensbury Town,New York Donation 4❑Removal Date Place Removed and/or and/or Held a Hold Address 1>L Date Point of U) Transportation Shipment a by Common Carrier Destination ❑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 1. Remains are Shipped,If Other than Above 5' Address t W Ct. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/06/2022 Registrar of Vital Statistics Megan Nolin(Electronically Signed) (signature/ District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition S Iq I 12_ Place of Disposition tt►t�, ��rL- 2 (address) W CC (section) n (lot number (grave number) Name of Sexton or Person in Charge of Premises (11 L_.. z (plse print) iLi , Signature - Title � � DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of ' '' ' delivered on , 20 l 1 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#