Demeo, Joseph # a30
NEW YORK STATE DEPARTMENT OF HEALTH 4-- (N-j
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joseph J Demeo Male
Date of Death Age If Veteran of U.S. Armed Forces,
04/05/2014 94 years War or Dates Navy
} a of Death Hospital, Institution or
City, Towrxgll.. Glens Falls Street Address Park St Glens Falls, N Y
Ili0 ner of Death k Natural Cause ❑Accident ❑Homicide 0 Suicide ❑Undetermined Pending
Circumstances Investigation
ILI Medical Certifier Name Title
Q Craig A Emblidge M D
Address
3 Irongate Plaza Glens Falls, N Y
th Certificate Filed District Number Register Number
City Towr c ll OO( Glens Falls 5601 173
urial Date Cemetery or Crematory
Entombment 04/08/2014 Pine View Cemetery
Address
Coemation Queensbury, NY 12804
Date Place Removed
Z Removal and/or Held
2,I—land/or Address
N} Hold
0 Date Point of
cch 0 Transportation Shipment
0 by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date " Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan & Denny Funeral Home 10441
Address
South Glens Falls, NY
Name of Funeral Firm Making Disposition or to Whom
} . Remains are Shipped, If Other than Above
;2 Address
Cr
W
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/07/2014 Registrar of Vital Statistics 1 Ck&.
(signat
District Number 5601 Place Glens Falls) XI 7
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
t
ILI Date of Disposition 4/9 iIt Place of Disposition ,it,Uu.,, 6 ,,tr;.--.
12 (address)
U)
CC (section) /4 (lot number) (grave number)
Name of Sexton or Pers in Charg of Premises "f'#°/!L St++,.44
Zr I (please print)
Signature �1.._ Title COEivitIlat
(over)
DOH-1555 (02/2004)