Auricchio, Raymond • _ # 33.7
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Raymond Auricchio Male
Date of Death Age If Veteran of U.S.Armed Forces,
04/06/2021 65 Years War or Dates
Place of Death Hospital,Institution or
W City,Town or Village Buffalo Street Address Buffalo Center for Rehabilitation and Nursing
'p Manner of Death ❑X Natural Cause ❑Accident ❑Homicide 1=1 Suicide ❑Undetermined Pending
✓ Circumstances Investigation
W Medical Certifier Name Title
O Ryan Mikac DO
Address
1014 Delaware Ave,Buffalo,New York 14209
Death Certificate Filed District Number Register Number
City,Town or Village Buffalo 1401 1547
Burial Date Cemetery,Crematory or Facility Name
04/09/2021 Pine View Crematory
❑Entombment Address
X❑Cremation Queensbury Town,New York
❑Donation
0 Removal Date Place Removed
and/or and/or Held
f Hold Address
0
Date Point of
tD❑Transportation
a by Common Shipment
Carrier Destination
Date Cemetery Address
❑Disinterment
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Regan Denny Stafford Funeral Home 01443
Address
53 Quaker Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
F Remains are Shipped,If Other than Above
• Address
CC
W
a Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 04/09/2021 Registrar of Vital Statistics Itanrra f Afazfs(cE4ectronicallySrgned)
(signature)
District Number 1401 Place Buffalo, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
2 Date of Disposition 174 Place of Disposition
(address)
W
CC (section) (lot num r) (grave number)
G Name of Sexton or Person in Charge of Premis A n"1}.p% St ti► t
Z (plea print)
pV
W Signature Title awssiona.
DOH-1555(o7/18)p 1 of 2
fl
Public Health Law Sec. 4145(2b) I 7 4
Receipt
/
Human remains of delivered on " , 20
Pine View Cemetery Representing the funeral home named pu l7urial permit
Official Funeral Directors Reg.or License# j+ `