Pietrosanto, Joseph D. NEWYORK STATE DEPARTMENT OF HEALTH BUriat - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Joseph D.Pietrosanto I Male
Date of Death Age If Veteran of U.S.Armed Forces,
05/11/2020 89 Years Waror Dates 1951-1953
II. Place of Death Hospital,Institution or
Z City,Town or Village Saratoga Springs Street Address Wesley Health Care Center Inc
W Manner of DeathEl g
0 � Natural Cause Accident Homicide Suicide Undetermined Pending
W Circumstances Investigation
U
W Medical Certifier Name Title
Rick Teetz MD
Address
131 Lawrence St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 277
Burial Date Cemetery,Crematory or Facility Name
05/13/2020 Pine View Crematory
Entombment Address
)C Cremation Queensbury Town,New York
Donation
ZO Removal Date Place Removed
and/or and/or Held
~N Hold Address
O
IL Date Point of
N ❑Transportation Shipment
p by Common
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
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 05/13/2020 Registrar of Vital Statistics .9olan Paul Franck(Ekctrn)ricad S#aed�
(signature)
District Number 4501 Place Saratoga Springs, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H
Z Date of Disposition Place of Disposition vh ,(J U tZ°i.J
W (addre s/
2
W
N (section) Cumber /grave number/
Name of Sexton or Person in Charge of Premises Z"�rr
0 (please print)
W Signature Title
DOH-1555(07/18)p 172
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#