Monterosso, Joseph NEW YORK STATE DEPARTMENT OF HEALTH -Vital Records Section Burial Transit Permit
Name First Middle Last Sex
JOSEPH MONTEROSSO Male
Date of Death Age If Veteran of U.S. Armed Forces,
�- Au crust 19 1999 81 War or Dates World war II
Z Place of Death Hospital, Institution or
W City, Town, or Village GLENS FALLS Street AddressGLENS FALLS HOSPITAL
Manner of Death 0 Natural Cause Accident Homicide Suicide Undetermined Pending
W Circumstances Investi atio
G Medical Certifier Name Title
W SUZANNE M. RAYESKI D.O.
Q Address
MAIN ST. WARRENSBURG NEW YORK 12885
Death Certificate Filed District Number Register Number
City, Town or Village GLENS FALLS 5601
Date Cemetery or Crematory
❑Burial Au crust 23 1999 PINE VIEW CREMATORY
Cremation Address
QUAKER RD OUEENSBURY, NY 12804
Date Place Removed
Removal and/or Held
and/or Address
Hold
Date Point of
Transportation Shipment
by Common Destination
Carrier
Disinterment
Date Cemetery Address
❑Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home BARTON-McDERMOTT FUNERAL HOME,INC. 100147
Address
9 PINE ST. , CHESTERTOWN, NY 12817
Name of Funeral Firm Making Disposition or to Whom
Remains are Shipped, If Other than Above
Address
Permission is hereby granted to dispose of the human remains described ab ove s in to
Date Issued `l'j` Registrar of Vital Statistics _ 4
(signature)
District Number 601 Place GLENS FALLS,New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition -vim - Place of Disposition
(address)
(section) (lot number) rave number)
Name of Sexton or Person in Charge of Premises �17�f j�J�� &d ZW AJ
(please print)
Signature Title ��/�