Battiste Sr., Frank 1@, ,
Town of Queensbury
Certification of Cremation
V41F Pine View Cemetery and Crematory
This certifies that the remains of: Frank Battiste Sr.
were cremated on May , 14 20 21 at the Pine View
(Month) (Day)
Crematorium, Queensbury,New York, and these are the cremated remains of said body.
Date of Death May , 12 20 21 Age 64
(Month) (Day)
Funeral Home Baker Funeral Home Registered No. 418
(Authorized Signature)
BATTISTE
NAME Frank Battiste Age: 64 —`
Lot Owner: Paula Battiste
Lot# Erie 27 E Grave# 1
Case: Urn
Died: 5/1 4/2 0 21 Interred55/1 8/2 0 21
Funeral Home: Baker FH
Cemetery: Pine View
ra
0 if `lit
NEW YORKSTATE DEPARTMENT OF HEALTH t,— } .` Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Frank Battiste Sr. Male
Date of Death Age If Veteran of U.S.Armed Forces,
05/12/2021 64 Years War or Dates
H Place of Death Hospital,Institution or
WCity,Town or Village Queensbury Town Street Address 6 Midnight Drive, Queensbury Town, New York 12804
p Manner of Death I1 Natural Cause ❑Accident 1=1 Homicide 1=1 Suicide ❑Undetermined 0 Pending
W C.) Circumstances Investigation
W Medical Certifier Name Title
CI Aqeel Gillani MD
Address
100 Park St,Glens Falls,New York 12801
Death Certificate Filed District Number Register Number
City,Town or Village Queensbury 5657 106
Burial Date Cemetery,Crematory or Facility Name
05/14/2021 Pine View Crematory
Entombment Address
gCremation Queensbury Town,New York
ElDonation
ZZ CI Removal Date Place Removed
and/or and/or Held
F Hold Address
N
0
G. Date Point of
(A Li Transportation Shipment
Q by Common
Carrier Destination
Disinterment
Date Cemetery Address
Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Maynard D Baker Funeral Home 01130
Address
11 Lafayette St,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
I— Remains are Shipped,If Other than Above
5. Address
CC
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 05/13/2021 Registrar of Vital Statistics Carolinexldgarde Bar6er(ElectronicalT Signed)
(signature)
District Number 5657 Place Queensbury, New York
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
I—
WDate of Disposition S'ily ill Place of Disposition ( *A�
2 address)
CC (section) 4(lot number) (grave number)
� L
0 Name of Sexton or Person in Charge of Pr ises +tea riot)
(P lP
Z /
W Signature C
�. Title G 11
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4145(2b) 0 1 4 7 R 6
Receipt
Human remains of delivered on , 20
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#