Ovitt, Oscar W. ig �
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Oscar W Ovitt Male
Date of Death Age If Veteran of U.S.Armed Forces,
09/28/2022 84 Years War or Dates
F., Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital
IJJ
p Manner of Death II Natural Cause nAccident Homicide Suicide FlUndetermined ri Pending
W U Circumstances Investigation
W Medical Certifier Name Title
Jennifer White DO
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed City Of Saratoga Springs District Number Register Number
City,Town or Village 4501 568
Burial Date Cemetery,Crematory or Facility Name
09/30/2022 Pineview Crematory
Entombment Address
EjCremation Queensbury Town,New York
Donation
❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
d Date Point of
CO OTransportation Shipment
p by Common
Carrier Destination
El
Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Densmore Funeral Home Inc 00448
Address
7 Sherman Ave,Corinth,New York 12822
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
a Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/29/2022 Registrar of Vital Statistics Dillon Moran(Electronically Signed)
(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:
1
Z Date of Disposition 91301 n Place of Disposition �,
2 (address)
W
CC CC (section) / (lot number - (grave number)
aName of Sexton or Person in Charge of Premises I t,�lease wJ ft
Z l t p print/
W Signature �C CSC Title rPo c
DOH-1555(07/18)p t of 2
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg. or License#