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Wachter, Peter 3 L&- NEWYORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Peter Wachter Male Date of Death Age If Veteran of U.S.Armed Forces, 04/11/2020 60 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Hempstead Town Street Address Nassau University Medical Center p Manner of Death © Natural Cause Accident Homicide Suicide ❑Undetermined Pending Circumstances Investigation W Medical Certifier Name Title 0 Zachariah Zaffuto DO Address 2201 Hempstead Tpke,Hempstead Town,New York 11554 Death Certificate Filed District Number Register Number City,Town orViltage Hempstead 2950 Burial Date Cemetery,Crematory or Facility Name 04/15/2020 Pine View Cemetery and Crematory Entombment Address 0 Cremation Queensbury Hamlet,New York Donation 0 Removal Date Place Removed and/or —7and/or Held H N Hold Address O lL Date Point of (a ❑Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address In Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home N F Walker Inc 01234 Address 2039 Merrick Avenue,Merrick Hamlet,New York 11566 Name of Funeral Firm Making Disposition or to Whom I— Remains are Shipped,If Other than Above 2 Address iM W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/14/2020 Registrar of Vital Statistics TathCeen Murray(ECectronicaCfy Signed) (signature) District Number 2950 Place Hempstead, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: F z Date of Disposition 41�� I� Place of Disposition OL t� Uj (address) W N (section/ (lotnumber) (grave number) M aName of Sexton or Person in harge of Pre ' es It Z (pl se print W Signature Title w DO H-i555(07/18)p 1 of 2 i Public Health Law Sec. 4145(2b) Receipt s { Human remains of ;° r delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# ' {