Steinhauer, Albert L
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Albert Joseph Steinhauer Male
Date of Death Age If Veteran of U.S. Armed Forces,
. 08/28/2017 73 Years War Or Dates 1964-1966
Pote
Place of Death Hospital, Institution or
City, Town or Village Glens Falls Street Address Glens Falls Hospital
Manner of Death Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending
Circumstances Investigation
w Medical Certifier Name Title
— Michael Adams MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
�
City, Town or Village Glens Falls 5601 462
®Burial Date Cemetery or Crematory
09/01/2017 Pine View Cemetery
❑Entombment Address
❑Cremation Queensbury Town, New York
Date Place Removed
7;40 Removal and/or Held
and/or Address
Hold
Date Point of
fn Transportation Shipment
4 by Common Destination
A. Carrier
❑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
Remains are Shipped, If Other than Above
2 Address
Z
Permission is hereby granted to dispose of the human remains described above as indicated.
Date issued 08/31/2017 Registrar of Vital Statistics ito6err Acanis L&ctronuafiy,}Ygtred
(signature)
District Number 5601 Place Glens Falls, New York
Y I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
1.4
Date of Disposition Q Ii I/} Place of Dispositi n 2l r it 4). Z��.�2ow+v
(address)
ILI
.-- .13 - B
cti n) (lot number) (grave number)
Name of Sex on or Person in Charge of Premises O/t/A)16 L / 1) t<
II ( ase print)
= Signature ,- QLo(M Titl r � 9�
(over)
DOH-1555 (02/2004)