Stegman, Joan NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Joan Stegman Female
Date of Death Age If Veteran of U.S.Armed Forces,
01/01/2023 89 Years War or Dates
Place of Death Hospital,Institution or
ZCity,Town or Village Queensbury Town Street Address 155 Robert Gardens North#7,Queensbury Town,New York 12804
Manner of Death a Natural Cause Accident ❑Homicide Suicide Undetermined ❑Pending
VCircumstances Investigation
Medical Certifier Name Title
Q Robert Reeves 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 1
X Burial Date Cemetery,Crematory or Facility Name
01/05/2023 Pine View Cemetery
_Entombment Address
Cremation Queensbury,New York
❑Donation
s
02 El Removal
Date Place Removed
and/or and/or Held
N Hold Address
L
0. Date Point of
tf)E Transportation
aby Common Shipment
Carrier Destination
Disinterment Date Cemetery Address
ElReinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596
Address
407 Bay Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
F • Remains are Shipped,If Other than Above
I Address
1
CL Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/04/2023 Registrar of Vital Statistics Caroline 7fiCdegarde Barber(ECectronica1TySigned)
(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 permitp/h on:
Date of Disposition t .5, a3 Place of Disposition c9 I QucK ,_ R.o (tJ /d 'c/
W U C<YA Y t r c/ /Y�
y2i (address) /
to
O /7 icon/ Q1 /\ 07
(sect (lot number) (grave number)
8 Name of Sexton or Person in Charge of Premises n,-)i<_ 6.4;z-Ck_1271
1z •
C (please print)
Signature Title > j 1 r 1/271k--i-)dc�t7-f
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b)
012962
Receipt
Human remains o , ' ' , ' " delivered on i-A3“ " , 20
1/,,,e,"/"Alf,(X:14., ,
• iew Cemetery Representing the funeral home named on burial permit
cial Funeral Directors Reg.or License# ! k'' i
Stegman
NAME Joan Stegman t Age: 89
Lot Owner: Joan M Stegman
Lot# Mohican 91 D Grave# 2
Case: Concrete
Died: 1 . 1 .2 3 Interred: 1 5 .2 3
Funeral Home: Singleton Sullivan Potter
Cemetery: Pine View
Stegman
Lot No. 91-D
dress Blda 5 A�t 7 Rah .rt ,ardPns No Qi�PanGhnr NV i �RnaSection No.
iner Joan M. Stegman Plot Moh i ran
to 8/29/94
Approx. 67 Superficial ft. @
cation Bounded North by Vacant , South by Artibee , East by Vacant & Murphy, West by
Davis
rner Posts
marks
ed No. (and changes) 2 612
yment Record Paid in Full 8/29/94 ( $700 .00 )
cord of Interments , s
Charles L. Stegman 8/29/94
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