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Billetdoux, Sherry Lorraine 1-OF Town of Queensbury Certification of Cremation ra Pine View Cemetery and Crematory This certifies that the remains of: Sherry Lorraine Billetdoux were cremated on February , 11 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 , 8 20 23 Age 71 (Month) (Day) Funeral Home Regan,Denny,Stafford Funeral Home Registered No. 143 -- -i///,,N (Authorized Signature) BILLETDOUX (P!) Lot No. 2 I Address 15 Hilton Drive So. Glens, Falls , NY 128o3 Section No. Owner Sherry Billetdoux Plot Erie Date 7/14/2010 Approx. 33 Superficial ft. (§ Location Bounded on the North by Vacant , East by Vacant, West by Spellacy and Sout by Kelley Corner Posts — -' > ' Remarks 792-4496 Deed No. (and changes) 3676 Payment Record Paid in full on 7/14/2010 ($600.00) Record of Interments �a L' C frtt I V g SN,e_ `t 9)01eViioux E. NI s � C \AI 4 A ill y E. VACANT Form No. 01 Billetdoux �� NAME Sherry Lorrai lletdoukge: 71 Lot Owner: Sherry Billetdoux Lot# Erie 2I Grave# 2 Case: Urn Died: 2.8.2 3 Interred: 6. 1 0.2 3 Funeral Home: Regan Denny Stafford FH Cemetery: Pine View . 1..._(:jiF ,k,\,), ,, NEW YORK STATE DEPARTMENT OF HEALTH BureauBurial - Transit Permit of Vital Records Name First Middle Last Sex Sherry Lorraine Billetdoux Female Date of Death Age If Veteran of U.S.Armed Forces, 02/08/2023 71 Years War or Dates H Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ❑X Natural Cause Accident II:Homicide Suicide Undetermined Pending W Circumstances Investigation W Medical Certifier Name Title 0 William Cleaver MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 73 'Burial Date Cemetery,Crematory or Facility Name 02/10/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury,New York ▪Donation O❑Removal Date Place Removed and/or and/or Held NHold Address EDate Point of t/1❑Transportation Shipment 5 by Common Carrier Destination oDisinterment Date Cemetery Address ElReinterment Date Cemetery Address 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 I— 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 02/09/2023 Registrar of Vital Statistics Megan Nolin(Electronically Signed) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition Z//Zia Place of Disposition Pi du p Jy eij (pertA,--/D IJJ a (address) W cc (section) "�\ ,/ (t mantled (grave number) Q Name of Sexton or Person in Cha e of re ' es ► /9 rind �A p (please print) 2 .--.. W Signature Title C� DOH-1555(07/18)p 1 of 2 // 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#