Denardo, Anna E. (��l t °7
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Anna E.Denardo Female
Date of Death Age If Veteran of U.S.Armed Forces,
10/08/2022 92 Years War or Dates
F.. Place of Death Hospital,Institution or
WCity,Town or Village Queensbury Town Street Address 84 Barthel Lane,Queensbury Town,New York 12804
p Manner of Death ❑X Natural Cause Accident ❑Homicide Suicide Undetermined ❑Pending
W Circumstances Investigation
QMedical Certifier Name Title
David Cunningham MD
Address
3 Irongate Center,Glens Falls,New York 12801
Death Certificate Filed Town Of Queensbury District Number Register Number
City,Town or Village 5657 146
Burial Date Cemetery,Crematory or Facility Name
10/11/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town, New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
�- Date Point of
(I)❑Transportation
by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Brewer Funeral Home Inc 00211
Address
24 Church Street PO Box 500,Lake Luzerne,New York 12846
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped,If Other than Above
2 Address
W
a. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/11/2022 Registrar of Vital Statistics Caroline Hildegarde Barber(Electronically Signed)
(signature)
District Number 5657 Place Town Of Queensbury
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
F- 1
g Date of Disposition Mill jL Place of Disposition
(address)
W
(section) (lot number (grave number)
GName of Sexton or Person in Charge of Pr ises � /A - '►1Nt 11-
Z ease print /�
W Signature Title 6 Dr 07)1
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#