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Zito, Linda B
it SIS NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Linda B Zito Female Date of Death Age If Veteran of U.S.Armed Forces, 07/05/2023 76 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Queensbury Town Street Address 6 Nelson Road,Queensbury Town,New York 12845 p Manner of Death ❑X Natural Cause ❑Accident Homicide Suicide Undetermined riPending W Circumstances Investigation WMedical Certifier Name Title 0 Anthony Petracca MD Address 3 Irongate Center,Glens Falls,New York 12801 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 110 Burial Date Cemetery,Crematory or Facility Name 07/12/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York ['Donation 0❑Removal Date Place Removed and/or and/or Held N Hold Address (/)❑Transportation Date Point of $ by Common Shipment Carrier Destination Disinterment Date Cemetery Address pReintermentDate 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 a Address CC W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 07/12/2023 Registrar of Vital Statistics Carotin xffegartIe Barber(E(ectronica(Cy Signed) (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: Date of Disposition Is 211Z3 Place of Disposition j � N e V(t,e (1`-.e4nUJ a-Fcs 2 (address) uJ N (section) (lot nu ber) (grave number) 0 Name of Sexton or Person in Charge f Premises/y�'yltwJ� D (please print) W Signature °y v f// Title D�-f I oc— DOH-1555(07/18)p 1 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#