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Sovetts, Maria V • Town of Queensbury _ Certification of Cremation Pine View Cemetery and Crematory This certifies that the remains of: Maria V. Sovetts were cremated on May , 5 20 23 at the Pine View (Month) (Day) Crematorium, Queensbury,New York, and these are the cremated remains of said body. Date of Death May , 3 20 23 Age 95 (Month) (Day) Funeral Home Regan,Denny,Stafford Funeral Home Registered No. 396 (Authorized Signature) NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Maria V.Sovetts Female Date of Death Age If Veteran of U.S.Armed Forces, 05/03/2023 95 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Moreau Town Street Address 198 Bluebird Road,Moreau Town,New York 12803 ,p Manner of Death El Natural Cause Accident Homicide ESuicide Undetermined Pending Circumstances Investigation W▪ Medical Certifier Name Title Q Madison Zuis NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Moreau District Number Register Number City,Town or Village 4562 22 Burial Date Cemetery,Crematory or Facility Name 05/04/2023 Pine View Crematory Entombment Address Cremation Queensbury,New York DDonation Removal Date Place Removed ; and/or and/or Held Hold Address U)❑Transportation Date Point of S by Common Shipment Carrier Destination Disinterment Date Cemetery Address EIReinterment 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 }. Remains are Shipped,If Other than Above Address W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/04/2023 Registrar of Vital Statistics Brenda J(utter(E(ectronicalTySigned) (signature) District Number 4562 Place Town Of Moreau I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: ZIU Date of Disposition ,s(S ha Place of Disposition t... (aadress) W IE (section) (tot number) (grave number) gName of Sexton or Person in Charge of Premises LLL �- ft Z (pi se print) W Signature Title 4'� � DOH-1555(07/18)p t 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# ry SOVfiTTS Lot No. 1-A 3dress 94 Sheridan St_. . Glens Falls , NY 12801 Section No. wner Robert D . & Maria V . Sovetts Plot Abenaki ate 9/30/98 Approx . 67 Superficial f t. )cation Bounded on North by Bradley , South by Vacant , East by Vacant , West by WoQds . )rner Posts marks eed No. (and changes) 2 914 iyment Record Paid in Full 9/30/98 ($700 . 00) !cord of Interments Robert D. Sovetts 7/8/02 (CREM) Eff 1A) David Sovetts 6/22/2018 (CREM) Y /" fK — rn eto Soqe i-j-3 5,q a3 .N)L IA! c-r S m, No. 01 SOVETTS NAME Maria V. Sovetts Age: 95 Lot Owner: Robert D. & Maria V. Sovetts Lot# Abenaki Grave# 2 Case: Urn Died: 5.3 .23 Interred: 5. 9.23 Funeral Home: Regan Denny Stafford Cemetery: Pine View