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Cuva, Charlene F NEW YORK STATE DEPARTMENT OF HEALTH didil Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Charlene F Cuva Female Date of Death Age If Veteran of US.Armed Forces, 03/19/2023 74 Years War or Dates F.. Place of Death Hospital,Institution or WCity,Town or Village Greenfield Town Street Address 157 Howe Road,Greenfield Town,New York 12833 p Manner of Death El Natural Cause Accident Homicide OSuicide FlUndetermined Pending W Circumstances Investigation W Medical Certifier Name Title O David DeCelle Coroner Address 40 McMaster Street,Ballston Spa,New York 12020 Death Certificate Filed Town Of Greenfield District Number Register Number City,Town or Village 4557 8 Burial Date Cemetery,Crematory or Facility Name 03/22/2023 Pineview Crematory Entombment _ Address ©Cremation Queensbury Town,New York DDonation 0❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 Date Point of M❑Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom i— Remains are Shipped,If Other than Above N Address Q W C' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/21/2023 Registrar of Vital Statistics Karen S.Dowen(Electronically Signed) /signature) District Number 4557 Place Town Of Greenfield I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 3177 i23 Place of Disposition ,t____:. it- W (address) W CC (section) /l (lot num (grave number) S Name of Sexton or Person in Charge of Premises /i" rt (please print) z <R h+,�/L W Signature Title DOH-1555(ol/18)p id 2 x � y i J 8.2 0 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#