McKessey, Danielle Yvonne F s\ ci 36
NEW YORK STATE DEPARTMENT OF HEALTH - Transit Permit
Bureau of Vital Records Burial
Name First Middle Last Sex
Danielle Yvonne McKessey Female
Date of Death Age If Veteran of U.S.Armed Forces,
11/22/2022 38 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Warrensburg Town Street Address 3881 Main Street,Warrensburg Town, New York 12885
pManner of Death El Natural Cause Accident Homicide 0Suicide ❑Undetermined El Pending
W Circumstances Investigation
W Medical Certifier Name Title
G Connie Goedert Coroner
Address
1400 St Route 9, Lake George Town,New York 12845
Death Certificate Filed Town Of Warrensburg District Number Register Number
City,Town or Village 5660 22
Burial Date Cemetery,Crematory or Facility Name
11/29/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
Donation
ZZ❑Removal Date Place Removed
and/or and/or Held •
Hold Address
N
0
O. Date Point of
N❑Transportation Shipment
Q by Common
Carrier Destination
EI
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
1— Remains are Shipped,If Other than Above
5 Address
Q
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/28/2022 Registrar of Vital Statistics Pamela MGtoyd(`ECectronicallySigned)
(signature)
District Number 5660 Place Town Of Warrensburg
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
W Date of Disposition I1bol ZZ Place of Disposition .r K�
2 (address)
W
CC N (section) /1 (lot number) c, (grave number)
SName of Sexton or Person in Charge of Premises tl
Z (pl ase print)
W irxe
Signature Title �� �
DOH-1555(07/18)p 1 of 2
x 3 6
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#