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Watts, Peter A
t it N EW YORK STATE DEPARTMENT OF H EALTH Li r it Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Peter A.Watts Male Date of Death Age If Veteran of U.S.Armed Forces, 03/11/2023 82 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Corinth Town Street Address 23 Hack Road,Corinth Town,New York 12822 pManner of Death M Natural Cause []Accident ❑Homicide Suicide Undetermined ❑Pending ✓ Circumstances Investigation Q Medical Certifier Name Title Zachary Novakovic DO Address 211 Church St,Saratoga Springs, New York 12866 Death Certificate Filed Town Of Corinth District Number Register Number City,Town or Village 4553 5 Burial Date Cemetery,Crematory or Facility Name 03/14/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York IIIDonation 0❑Removal Date Place Removed and/or and/or Held ~ Hold Address N 0 d Date Point of CO ETransportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Brewer Funeral Home Inc 00211 Address 24 Church Street PO Box 500, Lake Luzerne, New York 12846 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 5 Address CC LU EL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/14/2023 Registrar of Vital Statistics Brenda L Peris(Electronically Signed) (signature) District Number 4553 Place Town Of Corinth I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: �/r� WDate of Disposition 3/i5 In Place of Disposition 't,w.... / G--. 2 (address) W N CC (section) (lot number) S (grave number) • Name of Sexton or Person in Charge remises /i•` ;No -L-- ti Z /'lease print) LU Signature Title (2f nyr>2 DOH-1555(07/18)p 1 of 2 791 Public Health Law Sec. 4145(2b) Receipt I Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#