Tobias, Margit NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Margit Tobias Female
Date of Death Age If Veteran of U.S.Armed Forces,
06/22/2023 85 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Queensbury Town Street Address 151 Aviation Road,Queensbury Town,New York 12804
p Manner of Death a Natural Cause Accident Homicide Duicide nUndetermined In Pending
W Circumstances Investigation
W Medical Certifier Name Title
G Marten Peterson
Address
3 Irongate Center,Glens Falls,New York 12801
Death Certificate Filed Town Of Queensbury District Number Register Number
City,Town or Village 5657 93
Burial Date Cemetery,Crematory or Facility Name
06/26/2023 Pine View Cemetery
Entombment Address
Cremation Queensbury Town,New York
Donation
ZO❑Removal Date Place Removed
- and/or and/or Held
- Hold Address
Ul
0
d Date Point of
N IIITransportation Shipment
Q by Common
Carrier Destination
Disinterment Date Cemetery Address
Date Cemetery Address
Reinterment
Permit Issued to Registration Number
Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596
Address
407 Bay Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
,.. Remains are Shipped,If Other than Above
2 Address
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 06/23/2023 Registrar of Vital Statistics Carolnexllegard Barb-er(Electronica(Signe4
(signature)
District Number 5657 Place Town Of Queensbury
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z Date of Disposition (Q.pl�-� Place of Disposition �� L 1f��}�, �D CL[CCI7Sbog/ ,
W (address)
W 1 ►‹nti \ a 3
N io (lot number) (grave number)
G Name of Sexton or Perso 'n Charge of Prem' c m c-"In i e
^� (please print)
W • 's'Signature Title
DOH-1555(07/t8)p i of 2
1 Public Health Law Sec. 4145(2b)
01298 5
Receipt
Human remains of delivered on . L. 0 t?620 --3
i ,a
me View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
LAWERENCE/TOBIAS
Owner
Margit Lawerence; Imre Tobias
Address Plot
151 Aviation Road, Queensbury, NY 12804 Horicon
Phone # Lot #
(518) 791 -2345; (51 8)409-4617 121
Deed # Date
3975 10/94/16
Cost Foundation Y - N
1200
Location
Bounded on the North by Vacant, South by Bishop
East by Howk and West by Path
Remarks
Record of Interments
1 George Tobias 10/26/16 FB 6
2as .a3
m Qc►T-Tc,\0ic1s 10 ao• 3
3 8
4 9
5 10
3 ✓' w
0
s
x X ct- s < >iv
v 0
P �
2
%,I 0,..01(
TOBIAS
NAME Margit Tobias Age: 85
Lot Owner: Margit & Lawerence Tobias
Lot# Horicon 12 I Grave# 2
Case: Concrete
Died: 6.2 2.2 3 Interred: 6.2 6.2 3
Funeral Home: Singleton Sullivan Potter
Cemetery: Pine View