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Prestia, Theodore z 10 NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Theodore Prestia Male Date of Death Age If Veteran of U.S.Armed Forces, 03/05/2020 65 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Hempstead Town Street Address 2156 Grand Avenue,Baldwin,Hempstead Town,New York 11510 p Manner of Death Natural Cause Accident Homicide Suicide Undetermined ©Pending W () Circumstances Investigation Q Medical Certifier Name Title Michael DeMartino MD Address 2251 Hempstead Turnpike,East Meadows Hamlet,New York 11554 Death Certificate Filed District Number Register Number { City,Town or Village Hempstead 2950 tit Burial Date Cemetery,Crematory or Facility Name 03/10/2020 Pineview Crematory Entombment Address Cremation Queensbury Town,New York Donation Z Removal Date Place Removed O 0 and/or and/or Held Hold Address U) RN❑Transportation Date Point of 93 by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home N F Walker Of Queens Inc 01235 Address 87 34 80th St,Woodhaven,New York 11421 Name of Funeral Finn Making Disposition or to Whom _ i. Remains are Shipped,If Other than Above A)t q 5 M lc �e..r A � Address r A us � �t'^�`�- Ave a' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/09/2020 Registrar of Vital Statistics K2tM6t77MuW(E1e?rmic41y9gd4 (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: Z Date of Disposition -3_jG-y.o20 Place of DispositionC'kmg W (address) W Q (section) (lot number) (grave number) SName of Sexton or Person in Charge of Premises S U:r- Z (please print) W Signature Title Mq 4 GF DOH-1555(oft p 1 of 2 Public Health Law Sec. 4145(2b)- Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#