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Monteleone, Nicholas
9 BIZ N EW YORK STATE DEPARTMENT OF H EALTH Bureau of Vital Records Burial - Transit Permit Name First Middle Last Sex Nicholas Giovani Monteleone Male Date of Death Age If Veteran of U.S. Armed Forces, 09/04/2019 34 Years War or Dates Place of Death Hospital, Institution or W City, Town or Village Albany Street Address Albany Medical Center Hospital C) Manner of Death ©Natural Cause Accident Homicide Suicide ❑ Undetermined ❑ Pending Circumstances Investigation U W Medical Certifier Name Title 0 Tara Fitzgerald NP Address 43 New Scotland Ave, Albany, New York 12208 Death Certificate Filed District Number Register Number City, Town or Village Albany 0101 1909 ❑ Burial Date Cemetery, Crematory or Facility Name Entombment 09/13/2019 Pine View Crematorium Address Cremation Queensbury Town, New York Donation Removal Date Place Removed 0 and/or and/or Held F- Hold Address N O d Date Point of N p Transportation by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Stpo Box 67, Hudson Falls, New York 12839 Name of Funeral Firm Making Disposition orto Whom l . Remains are Shipped, If Other than Above 2 Address W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 09/09/2019 Registrar of Vital Statistics rDanieCCe S Gi(Cespie (E(ectronically Signed) /signature/ District Number 0101 Place Albany, 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 R i n i 11 Place of Disposition W (address) W Cl) cc (section) (lotnumber)S� (grave number) 0 � Name of Sexton or Person in Charge of Premises 114 ��' L W � / Signature Title lease print/ DO H-1555 (o7/18) p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of �1 ✓ V1/12'0 K �i dgivered on J � 20 2 Pine View Cemetery R resenting the funeral home named O�uri }yormit Official Funeral Directors Reg. or License # % ` 7