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Hoyt, Cynthia A
# yL3 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Cynthia A Hoyt Female Date of Death Age If Veteran of U.S.Armed Forces, 05/08/2023 84 Years War or Dates F— Place of Death Hospital,Institution or WCity,Town or Village Halfmoon Town Street Address 24 Spice Mill Blvd, Halfmoon Town,New York 12065 W Manner of Death ❑X Natural Cause Accident El Homicide OSuicide Undetermined ElPending Circumstances Investigation W Medical Certifier Name Title Aqeel Gillani MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed Town Of Halfmoon District Number Register Number City,Town or Village 4559 45 Burial Date Cemetery,Crematory or Facility Name 05/12/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held N Hold Address 0 O. Date Point of (I)❑Transportation Shipment b by Common Carrier Destination Disinterment Date Cemetery Address • Reinterment Date Cemetery Address 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 Address W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 05/10/2023 Registrar of Vital Statistics Lynda A Bryan(ECectronica((y Signed) (signature) District Number 4559 Place Town Of Halfmoon I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z ` IlJ Date of Disposition ,593-?dZ3 Place of Disposition rJP (�i e�/ Cie*,w'�C` 2 (address) W N (section) (lot number) (grave number) G Name of Sexton or Person in Charge of emises r , (please print) W Signature Title 0 to�`�u'�c DOH-1555(07/18)p i of 2 • 4_ w Public Health Law Sec. 4145(2b) 1 1 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# LF Town of Queensbury 4611 Certification of Cremation Pine View Cemetery and Crematory This certifies that the remains of: Cynthia A. Hoyt were cremated on May , 13 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 , 8 20 23 Age 84 (Month) (Day) Funeral Home Singleton,Sullivan,Potter Funeral Home Registered No. 413 L UV (Authorized Signature) HOYT L Owner Gordon & Cynthia Hoyt Address Plot 139 Chestnut Ridge Road Queensbury, NY 12804 Oneida Phone # Lot # 518-743-1743 1R9_A Deed # Date 4057 5/30/2018 Cost Foundation Y - N 1200 Location Bounded to the North by Path, East by Road South by Vacant, West by Vacant Remarks h-),..Q L r a I'rc L011- 3 471 - I1e-55 Record of Interments 1 6 - ra. 0. 1 E5-- e-04\11-3 - 5.8 8 4 9 5 10 c? 8 � r A A4 0 L Q t * E A � pl` - / .P VA-c ! �T HOYT (1. - NAME Cynthia A Hoyt Age: 84 Lot Owner: Gordon & Cynthia Hoyt Lot# 189 A Oneida Grave# 2B Case: urn Died: 5.8.23 Interred: 9. 1 .2 3 Funeral Home: Singleton Sullivan Potter Cemetery: Pine View