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Picioccio, Pierrette , i It 5.101 \LW yor,,,, ,,,:,TATE CE PAP-MEN a:: HEALTH Vital ;1t4orfrds 13re,:li4trf, Burial - Transit Permit Pierrette R. Picioccio Female Oate ot Cfecith Age 1 It VQ1cran ct U.S Arme9-1 Forces 1 9/23/2013 74 'AIMDates no 1—: Place ul Deatn .4.eff.ipiterl jr Or z zu Town *..fsiXXXXx. Lake Luzerne 5.11rAF11 Aldress 1338 Lake Ave. ;W • ID Mann - r..f Dent 4r-_-734 Nrifirq1 1:alico 1-1 Acrident riHrA-mcd,? Li 3,,,c,:i. U--1 Lindlermfrti2d I-- Pmqding Ui —I C,,irmtancifls InvnT.tigation ft) C.11 .-,ft.itY•fl Nair i. Title CI George Siniapkin M.D. Palmer Ave. , Corinth, NY 12822 i . Deati Cerifficate F11 i.,-(fl L111...,1fict NLIrliPir Reg tr.li'l Nf..irlbel 1 1 km-0w1Ro60007c Lake Luzerne 5556 _ alir (..c!rneffery or Crematory DEI!iiif 9/30/2013 Pine View Crematory Di tit:mm[11Hr! 4 , ; LiCremalion Queensbury, NY Date Placo Tir?rnc.JvC.ii Z --1 If=3-s-nof,,at :lid or 11E-Ad #:) [ , - itr,:i,Cu 6 1 E::, ut „I APS , 1 L 1.4 A.J _ 1 r cS etlimpl:::: A j Li res,s, 1h1! ,f,orprri Or I 11:r::::::::.:;:lirlor:::1 D°te 7.1fatp Cr.-rie-tery Address -4;= iiivmluot Por rn t 1SS:It-9:1 to Nilt!li..., or Fifinral I-10w ifff Brewer Funeral Home, Inc. 24 Church St. , Lake Luzerne, NY 12846 I Regislration Numbfu, 00211 II_ R\F!Lir.--,aeircst 1---nrci,Esnt.i..,,d1;....ri-ift(firl tiVi..,fotkiih.i..z1_11:;:iono.A1:1:1111t,fii.oi r fp 1.11•• .. __ . ICL: Permission is hereby granted to dispose of the human r m ns descr ed abov as„inditatad 1; I Dille IS SUP.C: ,DI ''.i'till S tilt 61C :.... „„_„ ,..„:,„,„ .,--6,---z, r.,..„, e Le,t1.,c,i_e__. NY 49-4f5IL 1-- r:ortify '!har "nt-, t Piriatt15, :-.t riti! :-.10c.c,dori- id:-!;1Z14 cJ ilt--L'VE-: 'N.i-n9..64:..V.YEE---U :1 in il:Lc.,...a dance with this permit on Z UM nat.. 1::4 C111 .4.1Poitioli /0 Ilia Nat:o ff.c Dtt.:30 :Lfi R14011‘) CtIstief*".• ui a Oi X.A4,_, Sek4rt- _ in Ne,,,,, ,,, Slixtion cr --orson in Chart ii Pr ,• IZ /L AU .3 .14 - . ,tYt.71.71.qo pr.i-t:' ;riatt,r ir? 111-r,i,. Caen)61/4. (o',,pr:, 7,'DH-1-55-3 :22 20.2.41