Bianco, Daniel P 7.-
1 # 339
NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Daniel P.Bianco Male
_` Date of Death Age If Veteran of U.S.Armed Forces,
; 04/19/2022 80 Years War or Dates
• Place of Death Hospital,Institution or
City,Town or Village Lake George Town Street Address 44 Carriage Hill Road,Lake George Town,New York 12824
Ill
Q' Manner of Death n Natural Cause []Accident []Homicide Suicide Undetermined ri Pending
W 0Circumstances Investigation
W Medical Certifier Name Title
0
, Mark Hoffman MD
Address
° 100 Park St,Glens Falls,New York 12801
Death Certificate Filed Tow Of Lake George District Number Register Number
City,Town or Village 5651 8
Burial Date Cemetery,Crematory or Facility Name
04/20/2022 Pine View Crematory
Entombment Address
; 111Cremation Queensbury Town,New York
' ❑Donation
Q0 Removal Date Place Removed
and/or and/or Held
},,;a' Hold Address
N
0
IL Date Point of
CO[]Transportation
p by Common Shipment
Carrier Destination
, ElDisinterment Date Cemetery Address
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Alexander Baker Funeral Home 00037
:'i Address
3809 Main St,Warrensburg,New York 12885
4,,' Name of Funeral Firm Making Disposition or to Whom
• Remains are Shipped,If Other than Above
• Address
C
W
',' Permission is hereby granted to dispose of the human remains described above as indicated.
- Date Issued 04/20/2022 Registrar of Vital Statistics Patricia c,Jfc'lcjnneyScliuster(ECectronicallySigned)
(signature)
District Number 5651 Place Town Of Lake George
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
H
WDate of Disposition y la in - Place of Disposition r•btu,_, L
2 (address)
W
CO (section) (lot number) (grave number)
c i Name of Sexton or Person in Charge of Premise f"► 6�U
(p ase print)
Z
! (if- eir
7* Signature Title
DOH-1555(o7/18)p 1 of 2
Public Health Law Sec. 4145(2b) 1"
Receipt
Human remains of delivered on , 20
•
Pine View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#