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Svolos, Themetria NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Themetria Svolos Female Date of Death Age If Veteran of U.S.Armed Forces, 12/19/2022 98 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Schenectady Street Address Ellis Hospital 1p Manner of Death ❑X Natural Cause Accident Homicide OSuicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title 0 Mai Naito NP Address 1101 Nott Street,Schenectady, New York 12306 Death Certificate Filed City Of Schenectady District Number Register Number City,Town or Village 4601 1125 ©Burial Date Cemetery,Crematory or Facility Name 12/22/2022 Pine View Cemetery III Entombment Address Cremation Glens Falls,New York Donation goRemoval Date Place Removed and/or and/or Held N Hold Address 0 Q Date Point of Cl) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Daly Funeral Home Inc 00413 Address 242 McClellan St,Schenectady,New York 12304 Name of Funeral Firm Making Disposition or to Whom F Remains are Shipped,If Other than Above 2 Address Cr W a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/20/2022 Registrar of Vital Statistics Samanta R. Mykoo(Electronically Signed) (signature) District Number 4601 Place City Of Schenectady I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: II— W Date of Disposition /2.2Q_ a Place of Disposition p7 j 6)06 R6 6)[lccn5 J►/ 2 (address) (se r (lot number) /grave number) GName of Sexton or Person in Charge of Premises C �0 t C c�r- 12 Z (please print) W Signature 4 i t.E• oeyTitle l>/i t,�jr n DOH-1555(07/18)p 1 of 2 / Public Health Law Sec. 4145(2b) 012960 Receipt Human remains of t ; . • delivered on , 20 -._ • _ r e View Cemetefy"`` Representing the funeral home named of burial permit official Funeral Directors Reg.or License# 3 \� SVOLOS Lot No. 2 9-A address 4 c C r T.a nP Srnt i a , NY 12302 Section No. Dwner Thametria Svolos Plot Horicon Date 2/9/96 A nX ti7 Superficial ft. r Location Bounded on North by Gazetos, South by Vacant , Wt-- by Gazetos , East by Path . L'orner Posts Remarks Deed No. (and changes) 2724 Payment Record Paid in Full 2/9/96 ( $7 0 0 . 0 0 ) Record of Interments L Elia Gus Svolos 2/12/96 a-� ; n �r . �� a ca a"�y as V 41- 7 E C 5 6 41 0 7 B Form No. 01 Svolos NAME Themetria Svolos Age: 98 Lot Owner: Themetria Svolos Lot# Horicon 29A Grave# 2 CasConcrete Died: 1 2 . 1 9,2 2 Interred: 1 2/2 2,2 2 Funeral Home: Daly FH Cemetery: Pine View