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Mastrangelo, Helen 1100,. 4�9l NEWYORKSTATEDEPARTMENTOFHEALTH I Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Helen Mastrangelo Female Date of Death Age If Veteran of U.S.Armed Forces, 03/20/2021 95 Years War or Dates Place of Death Hospital.Institution or Z City,Town or Village Saratoga Springs Street Address 400 Church Street,Saratoga Springs, New York 12866 W Manner of Death ❑X Natural Cause Accident ❑Homicide Suicide ❑Undetermined Pending U Circumstances Investigation W Medical Certifier Name Title Mirabelle Beck NP Address 394-402 Church Street,Saratoga Springs,New York 12866 Death Certificate Filed District Number Register Number City,Town or Village Saratoga Springs 4501 206 ❑Burial Date Cemetery,Crematory or Facility Name 03/22/2021 Pine View Crematory ❑Entombment Address gCremation Queensbury Town,New York ❑Donation ZriRemoval Date Place Removed and/or and/or Held N Hold Address 0 d Date Point of N ❑Transportation p by Common Shipment Carrier Destination Date Cemetery Address ❑Disinterment 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 F- Remains are Shipped,If Other than Above 2 Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/22/2021 Registrar of Vital Statistics join PaulWanck(EledronrcallySigned) (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: Z Date of Disposition 3114 Place of Disposition . �L ) 111 (address) W CC CC (section) (lot nu ber) i (grave number) ` 1 Name of Sexton or Person in Charge Premises r' ��1 Z © (pi se print)1 lL Signature j( � Title (124rA DOH-1555(07/18)p i of 2 et,- Public Health Law Sec. 4145(2b) 1 iduq Receipt Human remains of delivered on ,' , 20 / • I /4 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#