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Giustino, Joesph Robert . - . . (605Q NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records ' Name First Middle Last Sex Joseph Robert Giustino Male Date of Death Age If Veteran of U.S.Armed Forces, 10/03/2021 36 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital p Manner of Death ©Natural Cause ❑Accident ❑Homicide 1=1 Suicide 1=1 Undetermined ❑Pending W Circumstances Investigation W Medical Certifier Name Title CI Scott Biasetti MD Address 100 Park St,Glens Fails,New York 12801 Death Certificate Filed District Number Register Number City,Town or Village Glens Falls 5601 439 ❑Burial Date Cemetery,Crematory or Facility Name 10/11/2021 Pine View Crematory ❑Entombment Address 0 Cremation Queensbury Town,New York ❑Donation Z Removal Date Place Removed and/or and/or Held N Hold Address 0 CI. Date Point of Cl) 1-1 Transportation Shipment p by Common Carrier Destination Disinterment Date Cemetery Address Date Cemetery Address ❑Reinterment Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 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 10/07/2021 Registrar of Vital Statistics gR96ertAndrew Curtis(E(ectronica1Ty Signed) (signature) District Number 5601 Place Glens Falls, New York I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Ir- Z Date of Disposition /d /3--2oV Place of Disposition 7J hI j �1 / !e. W (address) / W NCC (section) (lot number) (grave number) 0 Name of Sexton or Per in Charge of Premises !ram4t 676_, a i.4."-- z (please print) Signature Title DOH-1555(o7/18)p 1 2 019923 / n.Law Sec. 4145(2b) F. R8, Apt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# .. •