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Noonan, Alice C
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Alice C.Noonan Female Date of Death Age If Veteran of U.S.Armed Forces, 08/09/2023 61 Years War or Dates Place of Death Hospital,Institution or W City,Town or Village Chester Town Warren Street Address 466 Atateka Drive,Chester Town Warren,New York 12817 • Manner of Death IZ Natural Cause ❑Accident Homicide OSuicide Undetermined riPending U Circumstances Investigation WCJ Medical Certifier Name Title Lynn Keil PA Address 1340 State Route 9,Lake George Town,New York 12845 Death Certificate Filed Town Of Chester District Number Register Number City,Town or Village 5652 13 Burial Date Cemetery,Crematory or Facility Name 08/11/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held o Hold Address 0 Date Point of (/)❑Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Barton-Mcdermott Funeral Home Inc 00141 Address 9 Pine St,Chestertown,New York 12817 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above M Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 08/11/2023 Registrar of Vital Statistics Mindy Conway(`6CectronicalTy Signed) (signature) District Number 5652 Place Town Of Chester I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 4P-1 Z Z023 Place of Disposition PJ h 42-V r`Gc4J G 2 (address) W N (section) 6(lot number) (grave number) SName of Sexton or Person in rge of remises w/I G-6.t c rK 44.ti e (please print) W Signature Title e.-�-Q-rnG./-w/ (1/0t� DOH-1555(07/18)p 1 of 2 i Public Health Law Sec. 4145(2b) 171 q r:: 1 Receipt . „ Human remains of ' delivered on ' ' , 20.-A- , ..,,, . , i .. , .. ..,,-,,,, ,,- , , „, .. Pin,6 View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#