Catone, Pasquale Joseph NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Pasquale Joseph Catone Male
Date of Death Age If Veteran of U.S.Armed Forces,
12/24/2021 83 Years War or Dates 1956-1961
Place of Death Hospital,Institution or
Z City,Town or Village Queensbury Town Street Address Warren Center for Rehabilitation and Nursing
W Manner of Death1=1 1=11=1Undetermined Pending
W Natural Cause Accident Homicide Suicide ❑
Circumstances Investigation
LUj Medical Certifier Name Title
Wendy Steinhacker PA
Address
42 Gurney Ln,Queensbury Town,New York 12804
Death Certificate Filed District Number Register Number
City,Town or Village Queensbury 5657 249
❑Burial Date Cemetery,Crematory or Facility Name
12/28/2021 Pine View Crematory
Entombment Address
iCremation Queensbury Town,New York
❑Donation
1:1Removal Date Place Removed
and/or and/or Held
Hold Address
N
O
O. Date Point of
N ❑Transportation
p by Common Shipment
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
H Remains are Shipped,If Other than Above
i" Address
III
W
n' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 12/27/2021 Registrar of Vital Statistics Caroliinexkligarefe Bar6er(ElectronicallySWned/
(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:
II— ,� rr
W Date of Disposition /j 3Q.2pe/Place of Disposition w J
U NO V: CC'�ilii t
2 (address)
ILI
CCCC (section) (lot number) (grave number)
0 Name of Sexton or Person in Charge of Premises /YIU;v Woe, I�
(please print)
W Signature 4 N' Title LtSZz c-
DOH-1555(07/18)p t of 2
Public Health Law Sec. 4145(2b)
Receipt
Human remains of delivered on , 20 `'
Pine View Cemetery Representing the-funeral home named on burial permit
Official Funeral Directors Reg.or License# t< ,'-