Loading...
Mason, Sheila Ann NEW YORK STATE DEPARTMENT OF HEALTH lib Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Sheila Ann Mason Female Date of Death Age If Veteran of U.S.Armed Forces, 02/15/2024 87 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital pManner of Death Natural Cause Accident Homicide El Suicide Undetermined ElPending V Circumstances Investigation G Medical Certifier Name Title 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 99 Burial Date Cemetery,Crematory or Facility Name 02/20/2024 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York Donation Z❑Removal Date Place Removed and/or and/or Held - Hold Address 0 O. Date Point of U) Transportation p by Common Shipment Carrier Destination ODisinterment Date Cemetery Address Reinterment 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 II— Remains are Shipped,If Other than Above 2 Address Q W O. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/16/2024 Registrar of Vital Statistics Megan Nolin(E(ectronica1y 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: H Z Date of Disposition 2123101 Place of Disposition F "V:.i (' .'ytA` (address) W IE (section) (lot number) (grave number) g Name of Sexton or Person in Cha o r mises If. s- l fif (ptase print iW Signature Title 11 .1Zf DOH-1555(o7/i8)p i of 2 a l 7.;(7; 1 I 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#