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Constantine Jr.,Paul J. NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial - Transit Permit Name First Middle Last Sex Paul J Constantine Jr. Male Date of Death Age If Veteran of U.S. Armed Forces, 31�3 �6z� 78 War or Dates Place of Death . Hospital, Institution or City, Town o illag Ballston Spa Street Address 51 McMaster Street Ballston Spa, NY 12020 Manner of Death©Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined ❑Pending Circumstances Investigation Medical Certifier Name Title Christine Carle MD Address 2299 Route 9 Mechanicville, NY 12118 Death Certificat District Number Register Number City, Town or Ballston Spa 4520 7 ❑Burial Date Cemetery or Crematory March 24,2020 Pine View Crematory ❑Entombment Address ®Cremation Queensbury, NY Date Place Removed ❑Removal and/or Held and/or Address Hold Date Point of ❑Transportation Shipment by Common Destination Carrier ❑Disinterment Date Cemetery Address ❑Renterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Compassionate Funeral Care Inc. 00364 Address 402 Maple Avenue Saratoga Springs NY 12866 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped, If Other than Above Address Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued March 24,2020 Registrar of Vital Statistics -eq (signature) District Number 4520 Place Village of Ballston Spa certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition,a7-, Place of Disposition `, ,,tfL V.," i'11-04U46 f-'( (address (section) , (lot number (grave number) l Name of Sexton or Perso Char a of remises T ivaj E' i I ( lease print) Signature Title (over) DOH-1555(02/2004) Public Health Law Sec. 4145(2b) 013464 Receipt Human remains of . , delivered on , 20 Pineiew Cemetery Representing the funeral home named on burial--permit Official Funeral Directors Reg.or License#