Colangelo, Anthony Mario Pine View Cemetery & Crematorium
Quaker Road
Queensburyl NY 12804
(518) 745-4477 or (518) 745-4476
FUNERAL HOME:
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RETURN TIME:
DATE B TIME REMAINS ARRIVED AT CREMATORY: _IIISIIU B'(O(h
NAME OF FUNERAL DIRECTOR OR REGRISTERED RESIDENT DELIVERING REMAINS:
b- uned n . I . 4
NAME: _ 88*P1 / D /M(.[I CASTE B 4Z7
TYPE OF CONTAINER: / i4I`Md 64 LRI. EyEE
PLACE OF DEATH: Jnfdm6R }it'p I �9
ESTIMATED WEIGHT OF REMAINS 8 CONTAINER rMb
PLACED IN HOLD: fy 4M
PLACED IN REFRIGERATION:
DATE OF CREMATION: Ticl#T
TIME STARTED: LM P-1 TIME COMPLETEDN 7 4Ofn
PLACED IN RETORT: Nopn MOVED: _ L•mP �Qr�
RETORT 9 IN WHICH REMAINS WERE CREMATED: CLRO tl..FL (n i/
DETAILED REASON FOR DELAY IF REMAINS WERE CREMATED MORE THAN 48 HOURS
FROM TIME OF ACCEPTED DELIVERY:
NOTE THE CREMATION LOG SMALL BE RETAINED IN THE PERMANENT FILE OF THE CREMATORY.
oew,nn.�ner¢m. '
ONEWYOmK CI mete ie DIVISION OF rem„ern 3ev^E%
L� Cemeteries e a
Tw „n,.n osiHi ,a
Authorization for Cremation and Disposition
MIS arbor ff Form must be compleW and signed Prior n"I"q or remains NO nRVM.
Dan'. 011=0 Number gZl
Qmalay Nama'. Mae el Unneecry
Anthony,. 210uaxer Road Oueendery, NY 12E014 p� (518) 745d4T
CREMATION IS AN IRREVERSIBLE AND FINAL PROCESS.
Clearstory;caud but by Oletlrq NO remain of d asm and days w iw bakro Me remains Imor a memeGn Mamba+Mwn
May are sMietled to Intense heat and fame. That but and time will Maxwell and wnsums ewe ing All turns and metal.
whim are all that will be bX affair Cremation.
Faxrvdng taema4m,mm tremabn wi 11 nxe reaenexam eaoro m al w oil of Me remain and oMar mutual hum me mamlon
chamber, but Seem minimal dust and residue win lixery bIan boo ind.oMe aremacery wil separate InCi4nnad and breian number horn
tM remains ant New Irobbemal add krdan human win be disposed of ae repulse] by law. Us comaMd mural will he mechanically
rynpr2M Inchsmallpleatsantoa InWadeslenab wm ,nerorum. CmnandN aingm miyampu"rizwuntilno
Nngkmgmentlemcognluble"sMlmltlesue.
OPEN NG OFTHE CONTAINER
The vematory may Only open me count modirg IM unuemand!human remains In III circumstances,such as W crant Na
id Wofted a or to ensure met an material mentioned whblr mi nlum employees ordamaae the mmatoyp any. If
hum.n remain art dtlNered Ina contalnr whim Is not Nftable for ommal such as ceremonial or rend cuxsr.Me
ma"ry ll require Mama remain M mosed into a sulmMe wnnlreebarore x accepts;the remains. The combat of
cmMi tM banebrorremovel olremainvnll bO WMuded MfaeaxiNacs end will ha done In privary, wth6gnNaMrwgcL
OENTF CAT pI OF DECFA8E0
Nemw MDSeaud: AnMalYxndo LClerl}Jo MenWI5n1u5: reverberant
last Known MdM4. IO ehbman Sheet, Smeltge 5lxlrga.NY 178�
Pkw of Dead: saR"aN ll
Say Elm OF Asa. 67 DDe: 05104/1953 Deb OfNa . 07111=20 Fanmawmgm/'70
Desagfon MmskWwnniw In whim remain vdf AS ddiwx
Cardboard Box saM/ooden Base
PERed! MCONTROL OF b'SPO fflON
(Mmnfa)ln Mfa a msp ", nl=f DNE M we nWJwMp)
I amMB are the deaanaMd aced ante Ee2aeed d ne in a all or wmfiei Ircbumem WsMAAd amueM W Pudic
IMM Law Section Vot.
-OR-
IMbname nc xnoadedae meth decemel mru vekd a vaiL m instrument puuent W Purim Health Law Seaton 4201 or
nw in ad direNona for M combustion or he or Mr arms be and new am tlIe pemon(s)head Morfy a nder Public Heald Law
Sx agolantmawmeNMWaumonecmmafonof Metam ,n Mmede Nall throurrenuonshipar MedecourldNas
folioo.
Anthony Mario Colangelo
DOS-109I(Re, pNRD) Paam l Of
Authorization for Cremation and Disposition
(hnaarinwrl MeadWm)
Number 5 Ceaalp5m: Row Marie NllMb (scion)
1. Aparson del noted in mang pmauam to Public R Mlaw Eaton 420 1(3)
i. The surviving moral
U. The sun'Mng domestic paMar;
n. A"surmi red egMeen years of me or Oldwr
l Aaurviviy parent
I Asurrrvmg call no eghtean was of age or when
G. AI swirly aFpoinko guartllaq
g. My remn(s)officer years of ego w wan entigM to shme in the estate and who show dealt In randons,W Me hemauh:
a. A duly appointed fidudary M are scab;
9. A dxe Mend a m1mm who has wall a when statement pursuant W Pul real I.ew Such,al%(T)'.
10. Ach'ief fiBPl officer of a mulls or a public admen Nmbr appointed annual to na 5unoawe'9 coon Pro hum Ad'
IRA Any Other"i Mal6 aetly an behalf of Me deceased and who has ewwted a woman atao l pursuant W PWIIO reach
hawse don 4201p).
nL
(I,II AA�LL THREE of roe Wowl
f�IANe Mwby aMnn that has mi of Me museum!des not women a battery.Winery Food,Waver cell, Mioadve implant.
OrreMoedve device aM ndl anysuN mamnaMware removed pmrb Me ereruW'idMis AUNametlan FOnn. Fallumbrsmwe
Nlaa Items mo r No Manhattan may result In him W Me anyway"and cmmlbry gmnnel.
IAVe affim that instructions how been Roar W Rolland G. Npg
regarding Me removed of wry'wreoNl PrcpeM Or Other Mlnp Of value abidl Any pason mail below or any All member of tlM
dmasrfd memo,W focused PereV Crematory
Is not Reaoneibl6 find removal Of gsonal mans"in My connector or Me mmmre of My dceasd. Personal items NOR In Me
(cyonmrlmr or MI Me renal,fin m dW%ed br Ma cmmanon proms and canna bl yedeveh lNnmnw Malawi
RVI9VP Vine hereby lodwif Plne saw Cmmalory
vaW W Omnam Me mmins of demawd.
( ffWOFHICNAQ
now handy,amodn the named formed director W proved far Wlvay W and cremadn by inalbmam
mnaWq,If dwmedmew"ry In Me opinlon of the fawn l clnMq and W amen this hours W provide Me wmct na me and
ammes 01 such enemab cremmory.
FINAL MSPOSTIll"
Thepe autW wl In rdeive Me assumed remain ofMB dP M1Gr W consul q.
Name: fotwear"Forest Cam
Adsw: 4021tapb Aw., SantnaSplymu Nhtge% pat (518)Ledual
Td oemamd mmednw w mreawa wm d aispma m ea taws:
St FailefsumMs/
n ter ery reran Me pawn mmae.bow dose nm texe pmewdm d M.uemetea mmrn,
Piro New Crematory Is aNhwNad to firs possession Of
the r a'msto T�+vwrvr�.r Ganp"ea MFurwal GYw. In by delivery
me
onmi or 4 mil of ts..vxsa Anthony Mal GOlen
005-19�If0.W. Oul remw Ppe2of3
' I
Authoriuttion for Cremation and Disposition
plM,�yare�Mawgl
1 1�wit uraar.ram mat nma remain are nxeaimee wmm 1xp eaya moemamn,
Pine May Crematory sew drspme a me mn m,in
wMdom, al
an manse bk mover, audl as by Miami.
CRENAMIN CONTAIHERNRX
(lanE(GrvE ama Wonval
An um b W all as a mntaierbr me vemedd remure Ius Loren Wralaea]Im'n
am Is eeeadeed m mm".
IMN umartbnd Mat if Me um is Me,wall W Wd me entire man"nimmns,an Wltlonal had mimmer may to used for salary
-m-
1ffi— .m um is not Pat WaAawn INA umnffind Mel a an um Is pumA amail provided
Pine Vw Crcmmoa all platy me Manatee remain in
Ps�acnmp
a nyd temMmyon- lamer W dalinry.
nor,ANhaalaNbn ram was prdMad Ly Poll G. Han ya meNM at
Lam mausiea Fuenal GM, In
402 Mapla Ave. CarmoJn Spdrga, NY 125105
arms a0ned Mme Miami Mail as soneaa m In exacomon n�
WAe haw moral a rosepMee mpy of His Aumorhaam Form.
The"none)idanROed Wbw,INaro ma parson es)In control W dlepcsNm,who Wawmne this AWramshom farm,aMe4q
w m s seminal and comp4an"a of Me Inimmation commned In mro Auma4atlon Fe�rm,and limmmitims))Mee foregoing.
orudmis tSm y a y
R dwv FIAr - n �)�O� atem��l
a" maw Hluabwlm
50 Mal Sb"t Saral Sp rl NY 12089
Tqww�swse Mail
Ainwe
WITNESS: /J
Poll G. Han G
F t os vnvwawmr nweuve +"
Anmry Maw Ca4ryab
003INEHIPrv. NUZ)h Ppe3di