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Cady, Peter L NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Peter L.Cady Male Date of Death Age If Veteran of U.S.Armed Forces, 02/27/2024 64 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Bolton Town Street Address 4 Bluebird Lane,Bolton Town,New York 12814 0 Manner of Death El Natural Cause Accident Homicide 0Suicide Undetermined Ei Pending Circumstances Investigation W Medical Certifier Name Title C3 Lynn Keil PA Address 9 Carey Road,Queensbury Town, New York 12804 Death Certificate Filed Town Of Bolton District Number Register Number City,Town or Village 5650 2 Burial Date Cemetery,Crematory or Facility Name 02/29/2024 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation Removal Date Place Removed and/or and/or Held Hold Address CO O 0. Date Point of N Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address OReinterment 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 F. Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/28/2024 Registrar of Vital Statistics Jodi 2'etteys(Etectronica((y Signed) (signature) District Number 5650 Place Town Of Bolton I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— y' 7 W Date of Disposition Z I lq ?Id Place of Disposition -l! Z,,Jci/;.,‘ 2 (addressr W CC N (section) 1 (lot number) (grave number) 0 Name of Sexton or Person in Charge of P-remises l �o W / (pl se print) Signature ✓✓✓/.� Title 605414P4' DOH-1555(o7/i8)p 1 of 2 1 J • Public Health Law Sec. 4145(2b) 01 el " Receipt Human remains of delivered on , 20 • Pine View Cemetery Representing the funeral home named,on.burial permit 1 Official Funeral Directors Reg. or License#