Steinfeld, Steven Andrew NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Steven Andrew Steinfeld Male
Date of Death Age If Veteran of U.S.Armed Forces,
04/23/2020 67 Years War or Dates
Place of Death Hospital,Institution or
WCity,Town or Village Mount Kisco Town Street Address Northern Westchester Hospital Association
`p Manner of Death ❑X Natural Cause Accident Homicide Suicide Undetermined Pending
U Circumstances Investigation
W Medical Certifier Name Title
Dayna Yardeni MD
Address
400 E Main St,Mount Kisco Town,New York 10549
Death Certificate Filed District Number Register Number
City,Town or Village Mount Kisco 5946 122
Burial Date Cemetery,Crematory or Facility Name
05/01/2020 Pine View Cemetery and Crematorium
Entombment Address
)C Cremation Queensbury,New York
Donation
0 Removal Date Place Removed
and/or and/or Held
F- Hold Address
to
O
N Transportation Date Point of
p by Common Shipment
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Clark Funeral Home Inc 100340
Address
2104 Sawmill River Rd,Yorktown Heights,New York 10598
Name of Funeral Firm Making Disposition or to Whom
�.. Remains are Shipped,If Other than Above
Address
IX
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/29/2020 Registrar of Vital Statistics CarolynNe Aitt(Electron--ff Sy-d�
(signature)
District Number 5946 Place Mount Kisco, 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 Place of Disposition
W
X. (address)
W
N
Ir (section) (lot number) (grave number)
aName of Sexton or Person in Charge of Premises
(please print)Z
W Signature Title
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b)
01 : 7
Receipt
Human remains of delivered on , 20
i
Pine View Cemetery Representing the funeral home named on bur�a��permit
Official Funeral Directors Reg.or License#