Loading...
Michel, Lawrence NEW YORKSTATE DEPARTMENT OFHEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Lawrence Michel Male Date of Death Age If Veteran of U.S.Armed Forces, 04/17/2020 67 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Hempstead Town Street Address Mount Sinai South Nassau `Q Manner of Death © Natural Cause ❑Accident Homicide ❑Suicide Undetermined Pending V Circumstances Investigation WW Medical Certifier Name Title Anthony Lyon MD Address 1 Healthy Way,Hempstead Town, New York 11572 Death Certificate Filed District Number Register Number City,Town or Village Hempstead 2950 ❑Burial Date Cemetery,Crematory or Facility Name 04/25/2020 Pineview Crematory Entombment Address Cremation Queensbury Town,New York ❑Donation Q1:1Removal Date Place Removed and/or and/or Held F N Hold Address O IL Date Point of U) ❑Transportation by Common Shipment Carrier Destination ❑Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home NEW LEAF CREMATION 02058 Address 3930 LONG BEACH RD., ISLAND PARK,New York 11558 Name of Funeral Firm Making Disposition or to Whom Remains are Shipped,If Other than Above Address W IL Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/24/2020 Registrar of Vital Statistics XathCeen Murray(Electronically 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: Date of Disposition L/-29--W Ze) Place of Disposition f� ,,J CCern4)0"-14 W (address) W W (section/ (tot number) (grave number) Name of Sexton o er n i Ch rge of Premises _A,�'�"� e.-,a4A ie Zn �- /please print/ W Signature ` C/ itle �r �e�' New Leaf Cremation DOH-1555(07/18)p t of z Michel, Lawrence TR042520 FH11/CO5/039 Public Health Law Sec. 4145(2b) 0 1 6 6 Receipt Human remains of delivered on 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#