Begni Sr, Steven 41 5-C33
NEW YORK STATE DEPARTMENT OF HEALTH Vital Records Section Burial _ Transit Permit
Mi Name First Middle Last Sex
Steven A. Begni Sr. Male
Date of Death Age If Veteran of U.S. Armed Forces,
07/30/2014 73 days.. War or Date4960-1962
Place of Death Hospital, Institution or
)ity, Tow r age Wilton Street Addres8 Old Deer Camp Road
Manner of DeatJ Natural Cause ❑Accident 0 Homicide 0 Suicide ❑Undetermined ❑Pending
1.11 Circumstances Investigation
tu Medical Certifier Name Title
0 Charles Weissman Md
Address
1003 Louden Road Latham, Ny 12110
iiiii Death Certificate Filed District Number Register Number
ity, TowrKierige Wilton 4569 13
Niii❑Burial Date Cemetery or Crematory
❑Entombment 08/01/2014 Pine View Crematory
Address
QrCremation Queensbury, New York
Date Place Removed
g❑Removal and/or Held
ow and/or Address
I" Hold
U
Date Point of
tE Transportation Shipment
G by Common Destination
Carrier
iig❑Disinterment Date Cemetery Address
❑Reinterment Date Cemetery Address
Iii Permit Issued to Registration Number
Name of Funeral Homeompassionate Funeral Care, Inc 00364
ai Address
402 Maple Ave. Saratoga Springs N Y 12866
: Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
2 Address
iX
w
l' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued08/01/2014 Registrar of Vital Statistics 4% / K1 W47�
(signature) 1
iliii District Numbn69 Place Wilton
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
k p
tip Date of Disposition g--1-19 Place of Disposition `�t('rw C( 44(
(address)
ILI
0
CC (section) (lo umber) (grave number)
ZrName of Sexton or Person in Char a of Premises 1, 'itig
please rint)
Zr
Signature -t Title OK Mil
(over)
DOH-1555 (02/2004)