Caradonna Jr, Anthony NEW YORK STATE DEPARTMENT OF HEALT
Vital Records Section Burial - Transit Permit
▪t s Name First Middle S Last Sex
Anthony J. Caradonna Jr male
Date of Death Age If Veteran of U.S. Armed Forces,
1 2/28/201 7 4 War or Dates n/a
Y:
Place of Death Hospital, Institution or
City, Town or Village Queensbury Street Address 31B Hiland Springs Way
g Manner of Death Natural Cause Accident Homicide x Suicide Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
0. Terry Comeau Coroner
; Address
1340 State Rt 9 Lake George NY 12845
Death Certificate Filed District Number Register Number
City, Town or Village Queensbury S kA 1 i 9 0
e. ❑Burial Date Cemetery or Crematory
01 /03/2018 Pine View Crematory
❑Entombment Address
®Cremation Queensbury, NY
Date Place Removed
Z Removal and/or Held
and/or Address
H Hold
N
O Date Point of
NTransportation Shipment
3 by Common Destination
Carrier
Disinterment Date Cemetery Address
n Reinterment Date Cemetery Address
Permit Issued to Registration Number
::: Name of Funeral Home Singleton Sullivan Potter 01 596
Address
;r:: Queensbury New York
Name of Funeral Firm Making Disposition or to Whom
IRemains are Shipped, If Other than Above
Address
#: Permission is hereby granted to dispose of the human remains described above as indicated.
▪ Date Issued k - 3 - apt' Registrar of Vital Statistics --aa/lt --e'Q.c (2 C.o __..-
:if::
(signature)
District Number Sla c 1 Place Q Q C c-n 5 bi//j
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
W Date of Disposition (/ g (ig Place of Disposition fi),,A ./ l tvrai,
2 (address)
W
U)
O (section) , .(lot numb (grave number)
pName of Sexton or Person in Charge of Pre ises , 4,4417-
`Z a lease print)
Signature rr- Title /I' loft to
(over)
DOH-1555(02/2004)