Fecura, Richard raj
NEW YORK STATE DEPARTMENT QF HEALTH
Vital Records Section t . , Burial - Transit Permit
Name First Middle Last Sex
Richard E.Fecura Male
Date of Death Age If Veteran of U.S. Armed Forces,
05/25/2018 45 Years War or Dates
Place of Death Hospital, Institution or
rr City, Town or Village Saratoga Springs Street Address Saratoga Hospital
Manner of Death 177I
ptE Natural Cause ❑Accident ❑Homicide ❑Suicide ❑Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
Maria Vivenzio DO
Address
211 Church St,Saratoga Springs,New York 12866
':' Death Certificate Filed District Number Register Number
• City, Town or Village Saratoga Springs 4501 295
.'Li Burial Date Cemetery or Crematory
05/29/2018 Pine View Crematory
,E ❑. Entombment N Address
, ®Cremation Queensbury Town, New York
. Date Place Removed
1,N
❑Removal and/or Held
and/or Address
Hold
Date Point of
A Li Transportation Shipment
by Common Destination
Carrier
;:.
Disinterment Date Cemetery Address
• ❑Renterment Date Cemetery Address
til
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
, Permission is hereby granted to dispose of the human remains described above as indicated.
4 Date Issued 05/28/2018 Registrar of Vital Statistics Jokn P Franck(E(ectronica(fy Signed)
(signature)
District Number 4501 Place Saratoga Springs, New York
s I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
rr Date of Disposition Sl3i Iif Place of Disposition rti„,'— 4:„Aa—s
(address)11 (section) t number) (grave number)
Name of Sexton or Person in Charge of Premises N SI t
�I (plea e print)
Signature (� 'LI Title ek.frotirg,
(over)
DOH-1555 (02/2004)