Chandler, Lynda M NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Lynda M Chandler Female
Date of Death Age If Veteran of U.S.Armed Forces,
09/29/2022 75 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Greenfield Town Street Address 380 Sand Hill Road,Greenfield Town,New York 12833
`p Manner of Death 0 Natural Cause Accident n Homicide 0 Suicide Undetermined ri Pending
Circumstances Investigation
W Medical Certifier Name Title
Amanda Harrington PA
Address
1 West Avenue,Saratoga Springs,New York 12866
Death Certificate Filed Town Of Greenfield District Number Register Number
City,Town or Village 4557 27
EBurial Date Cemetery,Crematory or Facility Name
09/30/2022 Pineview Crematory
Entombment Address
ECremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
H Hold Address
0
tlf: Date Point of
N Transportation
El" Common Shipment
Carrier Destination
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
F Remains are Shipped,If Other than Above
• Address
Q
W
d Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/30/2022 Registrar of Vital Statistics Karen S.Dowen(Electronically Signed)
(signature)
District Number 4557 Place Town Of Greenfield
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition l0 2O2z. � �Place of Disposition r`,pf Q ,' �) C/`.��4-I'it
1!J (address)
�3
W
CC
N (section) (tot rumber) (grave number)
O Name of Sexton or Person in Charge Premises � 7��•�� Li/�O
(please print)
W Signature Title Op ecad or
DOH-1555(o7/18)p t of 2
_
Public Health Law Sec. 4145(2b) ill ' -.
Receipt a
Human remains of delivered on , 20
-
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License# -