Alfano, Claire E 7 .- ,
K.L.F). 4 ---)s-3
NEW YORK STATE DEPARTMENT OF HEALTH '
Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
Claire E.Alfano Female
Date of Death Age If Veteran of U.S.Armed Forces,
09/22/2022 89 Years War or Dates
H Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address 183 Bay St,Glens Falls,New York 12801
Man nerof Death EI Natural Cause DAccident Homicide C^ 'tide riUndetermined ❑Pending
W
v Circumstances Investigation
W Medical Certifier Name Ti'
G Lia Braioo NI
Address
9 Carey Road,Queensbury Town,New York 12804
Death Certificate Filed CityOf Glens Falls District Number Register Number
Cit E,Town or Village 5601 488
Burial Date Cemetery,Crematory or Facility Name
Addre2022 Pine View Crematory
Entombment Address
Cremation Queerebery,New York
DDonation
0 Removal Date Place Removed
p and/or and/or Held
W Hold Address
0
Q. Date Point of
N Dransportation
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Date Cemetery Address
El Reinterment
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
I— Remains are Shipped,If Other than Above
S Address
Q
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/22/2022 Registrar of Vital Statistics .livan,%o!rn(Mctmnlea/6 4nr9
(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 q I Z3'72. Place of Disposition j710,1/ kjy-et----.
W
2 (address)
W
U)
f= (section/ 'riot num (grave e number)
gName of Sexton or Person in Charge of Pr i es w\.�t1
Zlease print/IL
�`
W Signature Title LiVinl
1���
DOH 1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
1
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#