Onofrietto, Neil NEW YORK STATE DEPARTMENT OF HEALTH f P ! `c
Vital Records Section Burial - Transit Permit
;;K: Name First Middle Last Sex
Neil P. Onofrietto Male
:`: Date of Death Age If Veteran of U.S. Armed Forces,
S: March 3, 2014 88 War or Dates World War II
i` Place of Death Hospital, Institution or
City, Town or Village Lake George Street Address 20 Philips St
Manner of Death (Xi Natural Cause 1 (Accident ( (Homicide Suicide Undetermined Pending
Circumstances Investigation
' Medical Certifier Name Title
David Cunningham,and
Address
;;;.°3 Irongate Center,Glens Falls,NY 12801
,.:v v Death Certificate Filed District Number i� Register Number
City, Town or Village Lake George,NY ��2
,..1❑Burial Date Cemetery or Crematory
March 5,2014 Pine View Crematory
❑Entombment Address
EJ Cremation Quaker Road, Queensbury, NY 12804
Date Place Removed
Z I I Removal and/or Held
and/or Address
Hold
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0 Date Point of
NTransportation Shipment
p by Common Destination
Carrier
Disinterment Date Cemetery Address
I_ IReinterment Date Cemetery Address
;:-:- Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
-:gid Address
53 Quaker Road, Queensbury,NY 12804
.'°.' Name of Funeral Firm MakingDisposition or to Whom
v.:- p
Remains are Shipped, If Other than Above
Address
~Permission is herebygranted to dispose of the human remai s described above as i icated.
R::: p l�//
:; „ Date Issued /,c / Registrar of Vital Statistics ,0 p�,_
(signature)
`µ;;, District Number (O 2 0 Place Lake George,NY
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Z
W Date of Disposition 3h i'f Place of Disposition ZN .) co-tier:.....
W (address)
U)
I (section) / lot nu er) (grave number)
QName of Sexton or Person in Charge of Premises `J.1-0l. .i-
Z4 (please print)
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Signature Title G CEdite
(over)
DOH-1555(02/2004)