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Ragazzo, Alfred Joseph
37 NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Alfred Joseph Ragazzo Male Date of Death Age If Veteran of U.S.Armed Forces, 04/05/2021 71 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village South Glens Falls Village Street Address 8 Woodcrest Drive,South Glens Falls Village,New York 12803 W Manner of Death Undetermined Pending W © Natural Cause Accident Homicide Suicide Circumstances Investigation W Medical Certifier Name Title 0 Mary Stein NP Address 9 Carey Road,Queensbury Town,New York 12804 Death Certificate Filed District Number Register Number City,Town or Village South Glens Falls Village 4524 10 ElBurial Date Cemetery,Crematory or Facility Name 04/06/2021 Pine View Crematory Entombment, Address 0 Cremation, Queensbury Town,New York Donation 8- El Removal Date Place Removed and/or and/or Held ~ N Hold Address 0 o. Date Point of CD ❑Transportation El Common Shipment Carrier Destination El Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom i.. Remains are Shipped,If Other than Above 2 Address W a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/06/2021 Registrar of Vital Statistics Shannon Kelleher(Electronically Signed) (signature) District Number 4524 Place South Glens Falls Village, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z W Date of Disposition `J1�/ZI Place of Disposition 2 (address) W Cr N (section) (lo�t umber) (grave number) O G' tt 4414 G Name of Sexton or Person in Charge of Premise0. (please prim W Signature ;ill Title `t" tvY DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) - i1/15q7 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# 1