Catandella, George . irg-i
NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
George Joseph Catandella Male
Date of Death Age If Veteran of U.S. Armed Forces,
02/09/2015 88 years War or Dates
Place of Death Hospital, Institution or
W City, Top{ A(VAI� (X Saratoga Springs Street Address The Hortense& Louis Runin Dialysis Cente•
Manner of Death QNatural Cause ❑Accident ❑Homicide ❑Suicide D Undetermined ❑Pending
W Circumstances Investigation
W Medical Certifier Name Title
Amy Hogan Moulton
Address
2 Broad St., Glens Falls; N Y
Death Certificate Filed District Number Register Number
City, Topfg xgvi RiRIKX Saratoga Springs 4501 6P
❑Burial Date Cemetery or Crematory
❑Entombment 02/10/2015 Pine View Cemetery
Address
Dremation Queensbury N Y
Date Place Removed
Z ❑Removal and/or Held
2 and/or Address
l; Hold
0 Date Point of
CL
❑Transportation Shipment
C1 by Common Destination
Carrier
❑Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care, Inc. 00364
Address
402 Maple Avenue, Saratoga Springs, N Y 12866
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
• Address
C
W.
a' Permission is hereby granted to dispose of the human remains scr My3veriso ' icated.
Date Issued 02/10/2015 Registrar of Vital Statistics �"' 1
(signature)
District Number d501 Place Saratoga Springs
' I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
• Date of Disposition Z/ti I JS Place of Disposition ,Fr,V.,..,, L o ld t L,.✓
', , (address)
Ett
CO
CC (section) (lot number)( (grave number)
pName of Sexton or Person in Char a of Premises i Lr) e„
2 (please print)
ltE Signature Title Cik PI AITIZ
(over)
DOH-1555 (02/2004)