Brower, Gladys B NEW YORK STATE DEPARTMENT OF HEALTH ,�� Burial - Transit Permit
Bureau of Vital Records
Name First Middle � Last Sex
Gladys B.Brower Female
Date of Death Age If Veteran of U.S.Armed Forces,
03/31/2024 99 Years War or Dates
f.. Place of Death Hospital,Institution or
W City,Town or Village Glens Falls Street Address Glens Falls Hospital
a Manner of Death ❑X Natural Cause Accident Homicide Suicide Undetermined Pending
W Circumstances Investigation
W Medical Certifier Name Title
0 Mathew Varughese DO
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 178
x.Burial Date Cemetery,Crematory or Facility Name
04/04/2024 Pine View Cemetery
Entombment
_ Address
Cremation Queensbury Town,New York
Donation
ZO❑Removal Date Place Removed
and/or and/or Held
~ Hold Address
N
0
G. Date Point of
Cl)❑Transportation Shipment
$ by Common
Carrier Destination
Disinterment Date Cemetery Address
❑Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
i.. Remains are Shipped,If Other than Above
2 Address
Q
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/01/2024 Registrar of Vital Statistics Megan.No(in(E(ectronica1Ty 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:
W L\Date of Disposition _� ,,t Place of Disposition s.1 ot,Gke2 RD �1 k( _r tS\')(.J SO1 1 a "T
�) (address)
W NG�Ke_ne5Gu3 \t) le) to
Cl)it (section) `(lot number) (grave number)
i
S Name of Sexton or Person in Charge of Pre ' —C iThf =<\C --\—
(please print)
W Signature A,r4.4.;,
1 Title l�1 `e1--4'1<lAJ T�C
DOH-1555(07/18)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#
BROWER 10-B
Lot No.
Address 281-283 Bay Rd. , Glens Falls , N.Y. Section No.
Owner Benjamin Mills Brower and James Burton Brower Plot New Kenesaw
Date 12/1/60
Approximately 200 Superficial ft. 1.30 per sq. ft. _ 260.0Q
Location Bounded on n/e by grass path; on n/w by neid and Fullerton lots; on
s/e by Stickney and H. D. Barber lots; on s/w by Ohepontuc Ave.
Corner Posts
Remarks
Deed No. (and changes) 7 84.
Payment Record Paid in full 12/1/60
Form No. 01
Record of Interments
1 5
James B . Brower 3/4/99}� J J
..17.� cvN: ru IM. .R irn UN e.{r -- /3'-2. 6 l �1 tC..\' ',J• b c-cAx. .,r �1/At/`� l 1-09 i
1 Leona Esther Brower 10/31/89 7 1 GGG
.
6 James B. Brower //- ,'Y- �' 8
N
(T' %i 4's s I 0 ` Cif iH V--
•
f-- ' , 1
i 1,14
,
( i
c , J
j 1
1
C
v i
1/
i-
1 i �^
V
x
x` I I 1
C f/ ' PC /Y 7 c_% c" A v C,-
BROWER
NAME 1 LF Age:
G adys B Brower 99
Lot Owner: Benjamin & James Brower
Lot# New Kenesaw 10 B Grave# 6
Case: Concrete
Died: 3.31 .2 4 Interred: 4 .4 . 2 4
Funeral Home: Regan Denny Stafford
Cemetery: Pine View