Stradinski, John �1NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - ransit Permit
Name First Middle Last Sex
John Stradinski Male
Date of Death Age If Veteran of U.S. Armed Forces,
01 / 01 / 2017 68 War or Dates N/A
ii Place of Death Hospital, Institution or
City, Town or Village Street Address 88 Circular St.
iti
Q Manner of Death®Natural Cause 0 Accident 0 Homicide 0 Suicide Ti Undetermined 0 Pending
Circumstances Investigation
Lii Medical Certifier Name Title
its John P.. Mongan DO
Address
6 Medical Park Dr #200, Malta, NY 12020
Death Certificate Filed District Number ' Register Number
City, Town or Village
c]Burial Date Cemetery or Crematory
' / 03 / 2017 Pine View Crematory
iii;ii nEntombment Address
tili Cremation Queensbury, NY
Date Place Removed
2❑Removal and/or Held
and/or Address
Hold
Date Point of
Q Transportation Shipment
by Common Destination
gii Carrier
ii: Q Disinterment Date Cemetery Address
0 Renterment Date Cemetery Address
ni Permit Issued to Registration Number
iiiiiV Name of Funeral Home Compassionate Funeral Care 00364
Address
402 Maple Ave. , Saratoga Sp. , NY 12866
giill Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
X Address
CC
w
tii Permission is ereby ed bove granted to dispose of the human remains ' 'cated.
• Date Issued 1 3I 11 Registrar of Vital Statistics
1
(signature)
liii District Number `ib I Place JCir.aibla ri n -' New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
ILI
Date of Disposition 1 I E 117 Place of Disposition Fn*Olz� (.4''n ofty�-
(address)
Ili
tC (section) (lot number) (grave number)
f ff
0 Name of Sexton or Person ip Charge of Premises ` f f Jt"��'�
2 j (pl se print) .
Signature Title t1Eit Q.
(over)
DOH-1555 (02/2004)