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Horwitz, Sylvia Celia • NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Sylvia Celia Horwitz Female Date of Death Age If Veteran of US.Armed Forces, 08/22/2023 100 Years War or Dates i.. Place of Death Hospital,Institution or Z City,Town or Village Queensbury Town Street Address 71 Longview Drive 166,Queensbury Town,New York 12804 tp Manner of Death ❑X Natural Cause ❑Accident ❑Homicide ESuicide ETUndetermined Ei Pending V Cra<umstances Investigation WL I Medical Certifier Name Title Madison Zuis NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed Town Of Queensbury District Number Register Number City,Town or Village 5657 128 Burial Date Cemetery,Crematory or Facility Name 08/23/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York DDonation ❑Removal Date Place Removed and/or and/or Held = Hold Address O a Date Point of N❑Transportation El Common Shipment Carrier Destination Disinterment Date Cemetery Address OReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Maynard D Baker Funeral Home 01130 Address 11 Lafayette St,Queensbury,New York 12804 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above 2 Address W a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/23/2023 Registrar of Vital Statistics Caroline 1fi&egarde Border(ECectronica1ty 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 V.ZG-jgZ 3 Place of Disposition (address) W Q (section) / (lot nu r) (grave number) 8 Name of Sexton or Person in Cha of P es �i4 7/Vey V j� �[� Z (please print/ W Signature —� Title d w DOH-1555(07/18)p 1 of 2 s 0 7225 Public Health Law Sec. 4145(2b) Receipt Human remains of t delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#