Ovitt, Scott A Sr. NEW YORK STATE DEPARTMENT OF HEALTH
Bureau of Vital.Records • Burial - Transit Permit
Name First Middle Last Sex
Scott A.Ovitt Sr. Male
Date of Death Age If Veteran of U.S.Armed Forces,
10/11/2022 61 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Lake George Town Street Address 9 E Schroon River Road,Lake George Town,New York 12824
p Manner of Death ❑X Natural Cause Accident Homicide OSuicide Undetermined ❑Pending
W Circumstances Investigation
W Medical Certifier Name Title
0 Lynn Keil PA
Address
1340 State Route 9,Lake George Town,New York 12845
Death Certificate Filed Town Of Lake George District Number Register Number
City,Town or Village 5651 19
Burial Date Cemetery,Crematory or Facility Name
IIIIMINI 10/13/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
DDonation
0❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
a Date Point of
(/)Dransportation
p by Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander Baker Funeral Home 00037
Address
3809 Main St,Warrensburg,New York 12885
Name of Funeral Firm Making Disposition or to Whom
IH Remains are Shipped,If Other than Above
2 Address
Q
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 10/12/2022 Registrar of Vital Statistics Patricia ,Mc7(inneySchuster(ECectronicalTySigned)
/signature/
District Number 5651 Place Town Of Lake George
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition /0�12("t2 Place of Disposition
2 (address)
W
CC N
(section) (lot number) (grave number)
SName of Sexton or Person in Charge of Premises 1
Z , (pie se print)
W Signature < Title
lR�m,g7L
DOH-1555(07/18)p t of 2
1 '_+r Tel t 1
Public Health Law Sec. 4145(2b)
Receipt
Human remains of - - ,f delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#