Lemedico, John 163
NEW YORK CITY THE CITY OF NEW YORK—DEPARTMENT OF HEALTH AND MENTAL HYGIENE
DEPARTMENT OF HEALTH OFFICE OF VITAL RECORggS
AND MENTAL HYGIENE PERMIT TO DISPOSE OF OR TRANSPO HUMAN REMAINS
April 29,2020 05:00 PM
156-20-037949
EVENT:(CHECK ONLY ONE) ®DEATH ❑SPONTANEOUS TERMINATION ❑INDUCED TERMINATION ------------ceRnFicare riuMaeR
NAME First,Middle,Last AGE I SEX I DATE I MONTH DAY Y YR)
OF
John Lomedico 78 Male EVENT 04 26 2020
PLACE OF BOROUGH NAME OF HOSPITAL OR INSTITUTION OR STREET ADDRESS
EVENT NEW YORK CITY
Bronx Providence Rest Nu'sing Home
NAME OF PHYSICIAN OR MEDICAL EXAMINER'S NUMBER METHOD ❑ INTERMENT I� CREMATION CREMATION APPROVED BY:
CERTIFIER OF ME/MLI Carla DeVito
Annamma John DISPOSAL ❑ OTHER M.E.CASE# B20025399
PLACE OF NAME OF CEMETERY OR CREMATORY(OR DESTINATION) CITY OR COUNTY AND STATE DATE MONTH DAY YEAR
OF (YYYY)
DISPOSITION Pineview Crematory Queensbury, New Y rk DISPOSITION 05 01 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 F3535
RESS CITY AND STATE N.Y.STATE REG.#
ESTABLISHMENT Schuyler Hill Funeral Home E Tremont Avel Bronx NY 01559
APPLICANT NAME OF N.Y.STATE LICENSED FUNERAL DIRECTOR(PRINT) I S ATURE J N.Y.STATE LIC.#
ewmhJeannine Carbone (r`//" ra Electronically Authenticated 10534
PERMISSION IS HEREBY GRANTED TO DISPOSE OF THE R r� UESTED ABOVE.
NOTICE: This permit is not valid without the seal of the Department ��! �'���•� Q�
of Health and Mental Hygiene;or if it has been corrected, • •
interlined or altered in an �—
y manner. A44
Cly Registrar
VR21(REV.7/09) FEE PAID$ 40.00 DATE 04 / 28 /2020 i ••, .•' By.Service Ev_ital
MM DD YYYY 4/y000
John LoMe ico
Schuyler Hill Funeral Home
TR050120 H06/C09/049
Public Health Law Sec. 4145(2b) 1313755
Receipt
Human remains of delivered on , 20_
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#