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Durkin, Judith C NEWYORKSTATEDEPARTMENTOFHEALTH f ithi� # IutS Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Judith C. Durkin Female Date of Death Age If Veteran of U.S.Armed Forces, 05/25/2023 83 Years War or Dates E.. Place of Death Hospital,Institution or Z City,Town or Village Johnsburg Town Street Address Elderwood at North Creek © Manner of Death 111 Natural Cause Accident 0 Homicide OSuicide Undetermined ❑Pending Ili U Circumstances Investigation 0 Medical Certifier Name Title Kate Sauer-Jones PA Address 112 Ski Bowl Rd,Johnsburg Town, New York 12853 Death Certificate Filed Town Of Johnsburg District Number Register Number City,Town or Village 5655 19 Burial Date Cemetery,Crematory or Facility Name e 05/26/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation ZZ❑Removal Date Place Removed and/or and/or Held F— Hold Address N 0 a Date Point of W❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Miller Funeral Home 01199 Address 6357 Nys Rte#30, Indian Lake,New York 12842 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/26/2023 Registrar of Vital Statistics Jean M Comstock(Electronically Signed) (signature) District Number 5655 Place Town Of Johnsburg I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— W Date of Disposition ,j Z7-Zoz3 Place of Disposition "P aj P Vie2 Cr.6 i44- j r,,\ 2 (address) W cc (section) / (lot /numberr (grave number) elName of Sexton or Person in Char a of Prises 7/YJI�� ,J ✓( �1 Z / l -(please print) W Signatures f Title lPr�l`t DOH-1555(07/18)p 1 of 2 V 1 69 5 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#