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Matte, Lesley Anne
.11 I NEW YORK STATE DEPARTMENT OF HEALTH lic5) ' Bureau of Vital Records Burial -Transit Permit Name First Middle Last Sex Lesley Anne Matte Female Date of Death r Age If Veteran of U.S.Armed Forces, 03/17/2024 70 Years War or Dates Place of Death Hospital.Institution or Z City,Town or Village Johnsburg Town Street Address Elderwood at North Creek W Manner of Death ©Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation W Medical Certifier Name Title C Wendy Steinhacker PA Address 112 Ski Bowl Rd,Johnsburg Town,New York 12853 Death Certificate Filed Town Of Johnsburg District Number Register Number City,Town or Village 5655 17 HBurial Date Cemetery,Crematory or Facility Name 03/18/2024 Pine View Crematory Entombment Address ®Cremation Queensbury Town,New York DDonation ZO❑Removal Date Place Removed and/or and/or Held H Hold Address 0 O. Date Point of Cl) Transportation $ by Common Shipment Carrier Destination E Disinterment 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 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 03/18/2024 Registrar of Vital Statistics jean ComstockgItctronica1ySigned) (signature) District Number 5655 Place Town Of Johnsburg I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I- W Date of Disposition 311'l 121 Place of Disposition .;�.c,✓c,F�.,► 1(ttl:.MATORPX- 2 (address) W CC (section) 1 (/pt number) S a. (grave number) g Name of Sexton or Person in Charge of Premises r� 1 �.'I t ,()gease,..,print) W Signature f Title /13k5/M VP DOH-1555(o7/18)p i of 2 r Public Health Law Sec. 4145(2b) l I Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License#