Fisher, Peggy Town of Queensbury
Certification of Cremation
Pine View Cemetery and Crematory
This certifies that the remains of: Peggy Fisher
were cremated on January , 7 20 21 at the Pine View
(Month) (Day)
Crematorium, Queensbury, New York, and these are the cremated remains of said body.
Date of Death January , 3 20 20 Age 85
(Month) (Day)
Funeral Home Baker Funeral Home Registered No. 20
(Authorized Signature)
L (,'' `\
NEW YORK STATE DEPARTMENT OF HEALTH Burial- Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Peter Norman Fisher Male
Date of Death Age If Veteran of U.S.Armed Forces,
08/20/2022 80 Years War or Dates
f- Place of Death Hospital,Institution or
ZCity,Town or Village Ticonderoga Town Street Address Elderwood at Ticonderoga
p Manner of Death El Natural Cause Accident Homicide 0Suicide nUndetermined Pending
C0 Circumstances Investigation
Medical Certifier Name Title
0 Kristin Mack DO
Address
1019 Wicker St,Ticonderoga Town,New York 12883
Death Certificate Filed Town Of Ticonderoga District Number Register Number
City,Town or Village 1564 39
Burial Date Cemetery,Crematory or Facility Name
immi 08/23/2022 Pine View Crematory
Entombment— Address
JCremation Queensbury Town,New York
Donation
Date Place Removed
On Removal and/or Held
F- and/or
Hold Address
In
TransportationDate Point of
n Shipment
® by Common
Carrier Destination
Disinterment E
Date Cemetery Address
Date Cemetery Address
■Reinterment
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079
Address
82 Broadway,Fort Edward,New York 12828
Name of Funeral Firm Making Disposition or to Whom
k Remains are Shipped,If Other than Above
Address
Q Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 08/22/2022 Registrar of Vital Statistics Tonya M'Thompson(ECectronicaay Signed)
(signature)
District Number 1564 Place Town Of Ticonderoga
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I-+
Z Date of Disposition e-Q.3—Zo?ZPlace of Disposition r,1 e V'4..4J ( rein 44a r
(address)
ILI
I (section) (lot number)1 (grave number)
•' Name of Sexton or Person in Charge of Pre 'ses l��l din v t l c/otid
z / f (please print)
tt Signature 1 T)r, 1 /" Title l�fL����i-1,1—
DOH-1555(o7/18)p 1 of 2
,.,4 0E;
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
,I
ue:
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
FISHER (LF\
NAME Peggy Fisher Age: 85
Lot Owner: James & Peggy Fisher
Lot# Oneida Crypt Grave#
Case: Urn
Died: 1 .3.2 0 2 0 Interred:1 0.8.2 2
Funeral Home: Baker FH
Cemetery: Pine View
FISHER
v
-
(1(-7-1-t) 155,156,157,
Lot No. 161,162,175
Address 2 Garner St., Glens Falls, N.Y. Section l' :
Owner James G. Fisher Sr.,& Peggy J. Fisher Plot One•
ida.
Date 7/27/77
600 Superficial ft. @ $2.50 per sq. ft.
Location Bounded on the North by Path, East by Path, South by Savale,Bowman, Fitzgibbon, West by
Road, Savale & Bowman
Corner Posts
Remarks The Deed listed_below replaces Deeds #1408 & 1416 which have been voided.
Deed No. (and changes) .1)1)15
Payment Record Paid in full 7/27/77
i
,
Form No. 01
Record of Interments
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