Lentini, Salvatore NEW YORK wTATE\JEPARTMENT OF HEALTH Burial - Transit Permit
Vital Records Section
T Name Firs Middle Lent. . Sex Male
alvatore
Date of Death Age If Veteran of U.S. Armed Forces,
03/02/2011 81 years War or Dates Korea
}- Place of Death Hospital, Institution or
Z g )4 own or I(jA Town Of Cortlandt Street Address Hudson Valley Hospital
Manner of Death Natural Cause 0 Accident Homicide 0 Suicide Undetermined Pending
Circumstances Investigation
ta Medical Certifier Name Title
0 Maunice Johnson
Adcwas
19bb Crompond Road, Cortlandt Manor
Death Certificate Filed District Number Register Number
1 own or itaggveX Town Of Cortlandt 5951 111
13$urial Date Cemetery or Crematory
03/08/2011 Pine View Cemetery
['Entombment Address
❑Cremation Queensbury, New York
Date Place Removed
❑Removal and/or Held
and/or
Address
t Hold
IA
0 Date Point of
Transportation Shipment
el by Common Destination
Carrier
Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan & Denny Funeral Home 01464
Address
53 Quaker Road, Queensbury, Ny 12804
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
cc
la
.? Permission is hereby granted to dispose of the human ains scrib above as indicated.
<` Date Issued 03/04/2011 Registrar of Vital Statistics / 4-i/`--
(signature)
District Number 5951 Place Town Of Cort andt
1-
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
2
If Date of Disposition 3/8/11 Place of Disposition Pine View Cemetery
(address)
la
ta Mohican 85 F 2
CC (section) (lot number) (grave number)
flName of Sexton or Person in Charge of Premises Michael Genier
(please print)
) Signature`( ^ .? `' Title Superintendent
(over)
DOH-1555 (02/2004)