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Urrato,Anthony ors NEWYORKSTATEDEPARTMENTOFHEALTH Burlal - Transit Permit Bureau of Vital Records Name First Middle Last Sex Anthony Urrato Male Date of Death Age If Veter�ofU.S.Armed Forces, 01/03/2020 70 Years War oPlace of Death Hospital,Institution or WCity,Town or Village Moreau Town Street Address 67 Fedor Road,Moreau Town,New York 12831 U Manner of Death ©Natural Cause Accident Homicide Suicide El UndeterminedPending Circumstances Investigation Medical Certifier Name Title David DeCelle Coroner Address 40 McMaster Street,Ballston Spa,New York 12020 Death Certificate Filed District Number Register Number City,Town or Village Moreau 4562 2 Burial Date Cemetery,Crematory or Facility Name 01/06/2020 Pine View Crematory Entombment Address Cremation Queensbury Town,New York Donation Z Date Place Removed 0 Removal and/or and/or Held Hold Address ❑Transportation Date Point of 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-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition orto Whom H Remains are Shipped,If Other than Above Address W IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/06/2020 Registrar of Vital Statistics Geeann 94c Cabe(ECectronicalTySigned) (signature) District Number 4562 Place Moreau, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H WDate of Disposition ]l 1 76 Place of Disposition iµ�c,/ a (address) W IW (section) (fit number/ (grave number/ rdName of Sexton or Person in Charge Premises tsjh}' z (pleas rint) W Signature Title DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 113 2-09 Receipt f r ' Human remains of delivered on + 20" Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#