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Reilly, Norma IA13LI NEW YORK STATE DEPARTMENT OF HEALTH • Burial. - Transit Permit Bureau of Vital Records Name First Middle Last Sex Norma Reilly Female Date of Death Age If Veteran of U.S.Armed Forces, 02/06/2023 85 Years War or Dates i,,., Place of Death Hospital,Institution or WCity,Town or Village Saratoga Springs Street Address Saratoga Hospital p Manner of Death 0 Natural Cause Accident Homicide Suicide Undetermined Pending V Circumstances Investigation W Medical Certifier Name Title C Suzanne Rayeski DO Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 93 HBurial Date Cemetery,Crematory or Facility Name 02/08/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation IS 0 Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 Date Point of N❑Transportation Shipment Q by Common Carrier Destination Date Cemetery Address Disinterment Date Cemetery Address 0 Reinterment Permit Issued to Registration Number Name of Funeral Home Regan Denny Stafford Funeral Home 01443 Address 53 Quaker Rd,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom F 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 02/08/2023 Registrar of Vital Statistics 'Dillon Moran(ECectronicallySigned) (signature) District Number 4501 Place City Of Saratoga Springs I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: V Z Date of Disposition 2/4 113 Place of Disposition i 4 — /tor.._ W (address) W U) (sedan) (tot number)C (grave number) gName of Sexton or Person in Charge of Premis /p(ereprint) Z (tt/ q c W Signature Title DOH-1555(07/18)p t of 2 -� 1.2,r' Ci 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# Town of Queensbury Certification of Cremation Pine View Cemetery and Crematory This certifies that the remains of: Norma Reilly were cremated on February 8 20 23 at the Pine View (Month) (Day) Crematorium, Queensbury,New York, and these are the cremated remains of said body. Date of Death February , 6 20 23 Age 85 (Month) (Day) Funeral Home Regan Denny Stafford Registered No. 134 (Authorized Signature) Reilly NAME Elm Age: Norma Reilly 86 Lot Owner: James& Norma Reilly Lot# Horicon 27C Grave# 2 Case: Urn Died: 2.6.23 Interred:2. 1 1 .2 3 Funeral Home: Regan Denny Stafford Cemetery: Pine Crematory ReillY Lot No. 27-C Address 5 Centennial Drive Queensbury N.Y. 12804 Section No. Horicen Owner James & Norma Reilly Plot Date 6/18/07___ _ ___ `��•�� Approx 33 Superficial ft. @ Location Bounded On North ByVacant, South By Vacant, West BY Vacant, East By Cavanagh. Corner Posts Remarks Phone 7935060 Deed No. ;‘and changes) 3491 Payment Record 6/18/07 Paid In Full ($550.00) Record of Interments t James Reilly 8/12/2019 (crem) 2 * _...._.. C. Form No. 01