Touart, Mary Joan ell
NEWYORKSTATEDEPARTMENTOFHEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Mary Joan Touart Female
Date of Death Age If Veteran of U.S.Armed Forces,
12/03/2023 82 Years War or Dates
i_ Place of Death Hospital,Institution or
Z City,Town or Village Glens Falls Street Address Glens Falls Hospital
MI• Manner of Death []Natural Cause Accident ri Homicide []Suicide []Undetermined Pending
✓ 1 'Circumstances Investigation
W Medical Certifier Name Title
CI Scott Biasetti MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 562
Burial Date Cemetery,Crematory or Facility Name
12/06/2023 Pine View Cemetery
Entombment Address
Cremation Queensbury Town,New York
Donation
0❑Removal Date Place Removed
and/or and/or Held
l Hold Address
N
0
a- Date Point of
U) Transportation
p by Common Shipment
Carrier Destination
[]Disinterment
Date Cemetery Address
II
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078
Address
136 Main St,S Glens Falls,New York 12803
Name of Funeral Firm Making Disposition or to Whom
F— Remains are Shipped,If Other than Above
Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/04/2023 Registrar of Vital Statistics Megan n gYectronicall:y Signed)
(signature)
District Number 5601 Place City Of Glens Falls
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:Z Date of Disposition j a L.o a5 Place of Disposition p!\. 0ucK� � ecJ \ c i (' / Q-i
Lu
2 (address)
w C"lp� }� 1 1 - 15
N cc (lion) , (lot number) (grave number)
O Name of Sexton or Person in Charge of Premises Cry�� l �►�� ctiO�
Z (please print)
W Signature Title.1� 1 G4
DOH-1555(07/18)p 1 of 2
C .,74O6
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#
PAVLUS
Lot No.12.13,311.15
Address 3426 last. Long Island City, N.Y. ///o / Section No.
Owner John Pavlus Plot
Mohawk
Date .. 9/12/80
400 Superficial ft. @ $1500.00
Location Bounded on the North by Vacant, East by Road, South by Vacant, West by Vacant
Corner Posts
Remarks
Deed No. (and changes) lhi 1
Payment Record Paid in full 9/12/80
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Form No. 01
Record of Interments
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Touart
NAME Mary Joan Touart e: 82
Lot Owner: John Pavlus
Lot# Mohawk 1 2-1 5 Grave# 7
Case: Concrete
Died: 1 2 .3 .2 3 Interred: 1 2.6.2 3
Funeral Home: M.B. Kilmer
Cemetery: Pine View