Loading...
Gallipoli, Linda June N EW YORK STATE DEPARTMENT OF H EALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Linda June Gallipoli Female Date of Death Age If Veteran of U.S.Armed Forces, 03/24/2020 J58 Years War or Dates ( Place of Death" Hospital,Institution or W' City,Town or Village North Hudson Town Street Address 3572 Nys Rt 9 Route,North Hudson Town,New York 12855 p Manner of Death ©W Natural Cause Accident Homicide Suicide Undetermined Pending („? Circumstances Investigation Medical Certifier Name13 Title Melanie Duerr Np Address 47 Tom Phelps Lane,Mineville Hamlet,New York 12996 Death Certificate Filed District Number Register Number City,Town or Village North Hudson 1 1561 03 Burial Date Cemetery,Crematory or Facility Name Fj03/25/2020 Pine View Crematory Entombment Address Cremation Queensbury Town,New York 11 Donation 0 Removal Date Place Removed F and/or and/or Held an Hold Address CL Date Point of ❑Transportation C� by Common Shipment Carrier Destination bisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Edward L Kelly Funeral Home 00519 Address PO Box 548,Schroon Lake,New York 12870 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above Address W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/25/2020 Registrar of Vital Statistics Martha 911. King(E(ectronicaCCy Signer) (signature) District Number 1561 Place North Hudson, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z'; Date of Disposition 3-,2�-fib Place of Disposition �} (ad ) W (section) (lot number) (grave number) 0 Name of Sexton or Person in Cha a of Premises C.� Z t�� (please pr nt) W; Signature Title DO H-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 013472 Receipt Human remains of delivered on , 20 Pide View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#