Loading...
Lambiaso, Patricia Star illE1) NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex - Patricia Star Lambiaso Female Date of Death Age If Veteran of U.S.Armed Forces, 02/21/2021 59 Years War or Dates Place of Death Hospital,Institution or City,Town or Village Queensbury Town Street Address 18 Kettles Way,Queensbury Town,New York 12804 Manner of Death ©Natural Cause El Accident Homicide Suicide Undetermined Pending Circumstances Investigation Medical Certifier Name Title Darci Gaiotti-Grubbs MD '`x Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed District Number Register Number .-�, City,Town or Village Queensbury 5657 56 ©Burial Date Cemetery,Crematory or Facility Name 02/26/2021 Pine View Cemetery _, Li Entombment Address , ElCremation Queensbury Town,New York . Donation Removal Date Place Removed rand/or and/or Held Hold Address Date Point of ❑Transportation Shipment by Common `:,-" Carrier Destination ❑Disinterment Date Cemetery Address ❑Reinterment Date Cemetery Address Permit Issued to Registration Number :._ Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596 Address 407 Bay Rd,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 described above as indicated. Date Issued 02/23/2021 Registrar of Vital Statistics Caroline Jfifeegarde Barber(ECectronica1Cy Signed) (signature) District Number 5657 Place Queensbury, New York t t- ` I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Date of Disposition 2/26/2021 Place of Disposition 21 Quaker Rd Queensbury, NY 12804 (address) Erie 56G 2. (section) (lot number) (grave number) Name of Sexto e"1-rson in Charg rem s Connie Goedert (please print) Signature " " °� Title Superintendent DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) 012844 Receipt Human remains of ; 'i, ', delivered on t 20..� Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# LAMBIASO limiC NAME Patricai Star Lambiaso Age: 59 LotOwner:Alex Lambiaso Kristen & Alex Lot# Erie 56 G Grave# 2 Case: Concrete Died: 2/21 /2 0 21 Interre2i�2 6/2 0 21 Funeral Home:Singleton Sullivan PotterLFH Cemetery: Pine View