Denegar, Steven . , , 21
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Steven Denegar Male
iiN Date of Death Age If Veteran of U.S. Armed Forces,
01 / 03 / 2015 31 War or Dates N/A
Place of Death Hospital, Institution or
ZCity, Town or Village Waterford Street Address 7 Grove St.
a Manner of Death❑Natural Cause 0 Accident E Homicide E Suicide 0 Undetermined ®Pending
ILICircumstances Investigation
ILL Medical Certifier Name Title
gt Michael Sikirica MD
Address
50 Broad St, Waterford, NY 12188
Death Certificate Filed District Number Register Number
City, Town or Village Waterford
>< MBurial Date Cemetery or Crematory
01 / 08 / 2016 Pine View Crematory
EiEntombment Address
Cremation 21 Quaker Raod, Queensbury, NY
Date Place Removed
Z❑Removal and/or Held
Rand/or Address
Hold
0 Date Point of
Q Transportation Shipment
ret by Common Destination
iig Carrier
Q Disinterment Date Cemetery Address
Q Reinterment Date Cemetery Address
i< Permit Issued to Registration Number
3 Name of Funeral Home Compassionate Funeral Care, Inc 00364
Address
iie 402 Maple Ave., Saratoga Springs, NY 12866
iiiii Name of Funeral Firm Making Disposition or to Whom
i.1Remains are Shipped, If Other than Above
Address
tu
::::
i her by granted to dispose of the human re ' 's escEibed ab as indi e; �
1 Registrar of Vital Statistics`/' / i
(signature)
District Number i Place Waterford , New York
Mi
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
2
Date of Disposition i/11111, Place of Disposition „ltuo„Ni ati.rAtq,4—
(address)
ita
I (section) (lot number) (grave number)
0 Name of Sexton or Person in Charge Premises . i
•, �4pitt
at (p ase print) •
•
'$ it
Signature Title
(over)
DOH-1555 (02/2004)