Loading...
Sgorrano, Peyer Lester 0�3 NEWYORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Peter Lester Sgorrano Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 12/27/2019 79 Years War or Dates 1958-1962 Place of Death Hospital,Institution or W City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death © Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending W C.) Circumstances Investigation OW Medical Certifier Name Title Sean Bain MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 557 ❑Burial Date Cemetery,Crematory or Facility Name ❑ 12/30/2019 Pine View Crematory Entombment Address 0 Cremation Queensbury Town,New York ❑Donation Z Date Place Removed - 0 ❑Removal and/or and/or Held N Hold Address O CL N ❑Transportation Date Point of O by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079 Address 82 Broadway,Fort Edward,New York 12828 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above Address W — (L Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 12/29/2019 Registrar of Vital Statistics `g96ert,4ndrew Curtis((6Cectronicaffy Signeq) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: L•- Z Date of Disposition f-fj p`lq Place of Disposition W (address) W N Q (section) (tot number) (grave number) aName of Sexton or Person in Charge of Premises r tf-c W (please print) Signature Title L(G DO H-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 013186 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing`the funeral home named on burial permit Official Funeral Directors Reg.or License#