Martelli, lorraine M. It 1 lei,
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NEWYORKSTATEDEPARTMENTOFHEALTH f
Bureau of Vital Records Burial - Transit Permit
Name First Middle Last Sex
Lorraine M.Martelli Female
Date of Death Age If Veteran of U.S.Armed Forces,
11/10/2020 83 Years War or Dates
Place of Death Hospital,Institution or
Z
City,Town or Village Saratoga Springs Street Address 223 Maple Ave,Saratoga Springs,New York 12866
Manner of Death 71
u. Natural Cause Accident ❑Homicide D Suicide ❑Undetermined Pending
WEi U Circumstances Investigation
0 Medical Certifier Name Title
Randall Burchell MD
Address
211 Church St,Saratoga Springs,New York 12866
Death Certificate Filed District Number Register Number
City,Town or Village Saratoga Springs 4501 572
❑Burial Date Cemetery,Crematory or Facility Name
11/13/2020 Pine View Crematory
❑Entombment Address
Cremation Queensbury,New York
Donation
6 0 Removal Date Place Removed
and/or and/or Held
N Hold Address
0
ltL 1-1 Date Point of
Cl) ❑Transportation
by Common Shipment
Carrier Destination
0 Disinterment
Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Compassionate Funeral Care Inc 00364
Address
402 Maple Ave,Saratoga Springs,New York 12866
Name of Funeral Firm Making Disposition or to Whom
l-- Remains are Shipped,If Other than Above
Address
CC
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 11/13/2020 Registrar of Vital Statistics 7oltnrPaulranck(Ekctronicall:yVae4
(signature)
District Number 4501 Place Saratoga Springs, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I-
W Date of Disposition ///'2'Z�O Place of Disposition g,Je �� � � ,ylGy�t•�
2 (addr
W
(
CC (section) (lot number)J (grave number)
• Name of Sexton or Person in Char of Premise >C J4�H10.t Oleo Cl
Z (please print)
W Signature //i/ Title DeQ7r1/4.7�J
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) ' 01 419 8
Receipt
Human remains of ) delivered on , 20
Pine View Cemetery Representing the funeral home named qn,burialermit
Official Funeral Directors Reg.or License# 1 >f