The URL can be used to link to this page

Chastain-Richardson, Tara A t _ # 15c NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Tara A Chastain-Richardson Female Date of Death Age If Veteran of U.S.Armed Forces, 02/19/2024 51 Years War or Dates • t` Place of Death Hospital.Institution or Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital WW Manner of Death Undetermined Pending IZINatural Cause Accident Homicide Suicide V Circumstances Investigation W Medical Certifier Name Title CI Hung Nguyen MD Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 113 Burial Date Cemetery,Crematory or Facility Name 02/21/2024 Pineview Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held H Hold Address N 0 Q. Date Point of (A❑Transportation CI Common Shipment Carrier Destination Date Cemetery Address Disinterment A.. Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address It W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/21/2024 Registrar of Vital Statistics Dillon Moran(Electronically Signed) (signature) District Number 4501 Place City Of Saratoga Springs I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z " W Date of Disposition Z IZZ(2� Place of Disposition '�S�vL�J <�irni��'— 2 (address) W CCCC (section) i (lot number) (grave number) /ii( Name of Sexton or Person in Charge o� ises (p se print z W Signature Title DOH-1555(07/18)p 1 of 2 , pd . 7C Q Public Health Law Sec. 4145(2b) y Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#