Dean, Joan -')
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records V
Name First Middle Last Sex
Joan L.Dean
Female
Date of Death Age If Veteran of U.S.Armed Forces,
07/07/2023 90 Years War or Dates
i— Place of Death Hospital,Institution or
WCity,Town or Village Schenectady Street Address Ellis Hospital
O Manner of Death ❑X Natural Cause illAccident Homicide El Suicide FlUndetermined ri Pending
W
✓ Circumstances Investigation
W Medical Certifier Name Title
O Sandra Perdek NP
Address
1101 Nott St,Schenectady,New York 12308
Death Certificate Filed City Of Schenectady District Number Register Number
City,Town or Village 4601 536
i&Burial Date Cemetery,Crematory or Facility Name
07/13/2023 Pine View Cemetery
Entombment
_ Address
▪Cremation Queensbury Town,New York
▪Donation
ZO❑Removal Date Place Removed
and/or and/or Held
H Hold Address
N
0
Date Point of
U) Transportation Shipment
Q by Common
Carrier Destination
Date Cemetery Address
Disinterment
Date Cemetery Address
Reinterment
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
CC
W
0-
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 07/10/2023 Registrar of Vital Statistics Samanta 4e Alykoo gkctronicaty S nea99
(signature)
District Number 4601 Place City Of Schenectady
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I—
Date of Disposition _1,t3. Place of Disposition at 4-tr1G Kcs 9 i' t,Ccnci r.. �i\)\ I �'
5 (address) `
W rjrAG►C14 4D i
to
CC (section) (lot number) (grave number)
GName of Sexton or Person in Charge of Premises Car N!x` Cc3C(pleas p Crint)
w 4Pam'- ;A k clCt)i
Signature /��� .1-.t Title L#
DOH-1555(o7/t8)p 1 of 2
Public Health Law Sec. 4145(2b) 12 9 9 1
Receipt
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Human remains of - , . r\\ , , , \ delivered on'•j ' -; I ) , 20
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l'!1>k_Y/L:"A(^••/' \. ,:', r ,i_,,. ---
View Cemetery Representing*e funeral home named on burial mmit
cial Funeral Directors Reg.or License# I J /( / 1
Form No. 01
Record of Interments
1
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2 1 Robert V. Lesperence (3/19/79) 1 6
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ttSPERENCE Robert V.
•
Lot No: 4�
kddress Section No.
44 Tarrilten AVP-� Olen Pa11s u_Y_
Dwner Mrs. Joan Lesperence Plot Oneida
Date 3/19/79
65 Superficial ft. @ $250.00
Location Bounded on the North by Arnold, East by Path. South by Vacant, West by Vacant
:orner Posts
r
Zemarks
Deed No. (and changes) 1524
'ayment Record Paid in full 3/19/79
DEAN
NAME Joan Dean \S. ) Age: 90
Lot Owner: Joan Lesperence
Lot# Oneida 42 Grave# 1
Case: Concrete
Died: 7.7.2 3 Interred: 7.1 3.2 3
Funeral Home: Regan Denny Stafford
Cemetery: Pine View