Tarantelli,Joseph NEW YORK STATE DEPARTMENT OF HEALTH
Vital Records Section Burial - Transit Permit
Name First Middle Last Sex
Joseph E. Tarantelli Male
Date of Death Age if Veteran of U.S. Armed Forces,
November 12, 1997 75 War or Dates World War II And Korean Conflict
Place of Death Hospital, Institution or
City, Town or Village Glens Falls N.Y. Street Address Glens Falls Hospital
Manner of Death Natural Cause Accident Homicide Suicide Undetermined Pending
Circumstances Investigation
Medical Certifier Name Title
Robert W. Sponzo MD
Address
103 Park Street Glens Falls, New York 12801
Death Certificate Filed District Number —]-Register Number
City, Town or Village Glens Falls, N.Y. 5601 -5 3
Date Cemetery or Crematory
❑Burial November 18, 1997 Pine View Crematory
Address
Ej Cremation _.__--Quaker_Road_Queen.sbury, New York
Date Place Removed
z ❑Removal and/or Held
••• and/or Address
Hold
Q Date Point of
F]Transportation Shipment
0 by Common Destination
Carrier
Disinterment Date Cemetery Address
Reinterment Date Cemetery Address
<° Permit Issued to Registration Number
XN
Name of Funeral Home Singleton-Healy Funeral Home 01773
Address
407 Bay Road Queensbury, New York 12804
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 de crriibedd above as kOcated.
Date Issued Nov. 18, 1997 Registrar of Vital Statistics
(signature)
District Number 5601 Place Glens Falls, New'York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
z Date of Disposition `, Place of Disposition / � Y / 1,� r✓ ��� ��Cl
(address)
W
(section) (lot Dumber) ) (grave number)
A Name of S n or Person in Charge of Premises �/,T
/ClLl
(please print) u
g
Signatureext
Title ✓ '
DOH-1555 (10/89) p. 1 of 2 VS-61