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Isaacs, Susan M
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records c Name First Middle Last Sex Susan M.Isaacs Female Date of Death Age If Veteran of U.S.Armed Forces, 09/04/2023 57 Years War or Dates .... Place of Death Hospital,Institution or WCity,Town or Village Warrensburg Town Street Address 3664 Main Street,Warrensburg Town, New York 12885 p Manner of Death Z Natural Cause ❑Accident El Homicide OSuicide FlUndetermined Pending W 0 Circumstances Investigation WW Medical Certifier Name Title CI Timothy Murphy Coroner Address 52 Haviland Avenue,Glens Falls,New York 12801 Death Certificate Filed Town Of Warrensburg District Number Register Number City,Town or Village 5660 12 Burial Date Cemetery,Crematory or Facility Name �' 09/08/2023 Pine View Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed H and/or and/or Held • CO Hold Address 0 0.. Date Point of Cl) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom 1.- Remains are Shipped,If Other than Above M Address C W Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/07/2023 Registrar of Vital Statistics Tame&W G(oyd(Electronically Signed) (signature) District Number 5660 Place Town Of Warrensburg I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I- Z Date of Disposition q I Q,Z 3 Place of Disposition Fa 4---, W 22 (address) LU to Q (section)g 747(lot number �stivo (grave number) Name of Sexton or Person in Charge of Pre 's n Z (pl a print) t!V Signature / Title I nfefilaa DOH-1555(o7/18)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# I, -