Salvaggio, Frank NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
Name First Middle Last Sex
Frank JoseP h Saluaggie..:. Male
Date of Death Age If Veteran of U.S. Armed Forces,
June22 A 1993 86 War or Dates World:::.War,:..1I
Place of Death Hospital, Institution or
W City Town or Village City of Glens FAlls Street Address
Glens_ :Fal. :,.:.Hcspit.a.l
Manner of Death ®'La Natural Cause ❑ Accident El Homicide ❑ Suicide Undetermined ❑ Pending
Circumstances Investigation
Medical Certifier Name Title
G:.:..: Robert W. ..Sponzo MD
Address
90 South Street, GlensFalls, NewYork128a1:..
Death Certificate Filed District Number Register Number
City,Town or Village City of Glens Falls (35/
Date Cemetery or Crematory
�j Burial June 24 1993 Pine„View_..Cemeter ....
❑Cremation Address
Queensbury, New York
z Date Place Removed
O ❑ Removal and/or Held
i and/or Hold .:::
Address
U)
a Date Point of
co ❑Transportation by Shipment
p Common Carrier ...: ::
Destination
❑ Disinterment Date Cemetery Address
❑ Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Firm Regan and Denny Funeral Service, Inc. 01602,,,,
Address
26 Quaker Road, Queensbury, New York 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
a
Permission is hereby granted to dispose of the human re des ribe above as indicated.
Date Issued g'/.2 9// Registrar of Vital Statisticsa..." ioi•-•
(signature)
District Number (`)/ Place ,9 2-1-e•-•(?)"2 t l 2e-.6(
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I-
Z Date of Disposition 6/24/93 Place of Disposition Pine View Cemetery Queensbury NY 12804
2 (address)
w S. I . #2 132 1
NCC (section) (lot number) (grave number)
pName of Sext Person in Charge of Premises Rodney G, . mosher
Z t (please print)
w Signature Title Sint _
DOH-1555 (10/89) p. 1 of 2 VS-61