Pierre, Enriquetta NEW YORK CITY THE CITY OF NEW YORK—DEPARTMENT OF HEALTH AND MENTAL HYGIENE
DEPARTMENT OF HEALTH OFFICE OF VITAL RECORDS
AND MENTAL HYGIENE
April 20,2020 03:04 PM PERMIT TO DISPOSE OF OR TRANSPORT HUMAN REMAINS
156-20-031588
EVENT:(CHECK ONLY ONE) M DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION ------.-----cE-RTIFicATe NUMBER
NAME First,Middle,Last AGE SEX I DATE MONTH DAY (YYR)
OF
Enriquetta Pierre 73 Female EVENT 04 20 2020
BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS
PLACE OF NEW YORK CITY
EVENT Manhattan New York Presbyterian Hospital
CERTIFIER
NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER METHOD ❑ INTERMENT X CREMATION CREMATION APPROVED BY:
OF MEIMLI Adrienne Grande
David Anstey DISPOSAL ❑ OTHER M.E.CASE#M20023059
PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE MONTH DAY YEAR
OF (YYYY)
DISPOSITION Pineview Crematory 1 Queensbury, NY DISPOSITION 04 25 2020
THE CERTIFICATE OF DEATH HAVING BEEN FILED AS REQUIRED BY THE HEALTH CODE,AND ALL LAWS AND REGULATIONS
GOVERNING THE PREPARATION AND DISPOSAL OF HUMAN REMAINS HAVING BEEN COMPLIED WITH, PERMISSION IS
HEREBY REQUESTED TO DISPOSE OF THE REMAINS AS IDENTIFIED ABOVE.
FUNERAL NAME OF ESTABLISHMENT ADDRESS CITY AND STATE N.Y.STATE REG.#
ESTABLISHMENT New Leaf Cremation 3930 Long Beach Rd Island Park NY 02058
APPLICANT
NAME OF N.Y.STATE LICENSED FUNERAL—DIRECTOR(PRINT) SIGNATURE N.Y.STATE LIC.#
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Michael Noll c/�Cc��oe SigeaNreE1,clmniwtyAu1M,b 1.d 14105
PERMISSION IS HEREBY GRANTED TO DISPOSE OF THE RE y UESTED ABOVE.
o� •� �•�Y
NOTICE: This permit is not valid without the seal of the Department ��••,,+•• �,,••r UQ�
of Health and Mental Hygiene;or if it has been corrected, • ' •s Q/� .t"'
interlined or altered in any manner. City Registrar
VR 21 (REV.7/09) FEE PAID$40.00 DATE 04 ( 24 )2020 * ••, •.•* By Service Ev---ital
MM DIDYYYY OF N •1 — —----
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1
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#