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Caparelli, Edward Joseph NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Edward Joseph Caparell Male Date of Death Age If Veteran of U.S.Armed Forces, 10/06/2022 86 Years War or Dates H Place of Death Hospital,Institution or Z City,Town or Village Glens Falls Street Address Glens Falls Hospital Manner of Death El Natural Cause ❑Acddent Homicide Suicide Undetermined ❑Pending W Circumstances Investigation W Medical Certifier Name Title 0 Shahid Ahmed MD Address 100 Park St,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number Cit ,Town or Village E5601 515 X Burial Date Cemetery,Crematory or Facility Name View 10/12/2022 Pine Cemetery Entombment Address Cremation Queensbuty Town,New York Donation ZZ❑Removal Date Place Removed and/or and/or Held N Hold Address 0 a Date Point of U)ElTransportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Date Cemetery Address ElReinterment 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 Otherthan Above "S Address CC fU a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 10/11/2022 Registrar of Vital Statistics AlqanNoRn(Electmnua(yS&wd) (signature! District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: W Date of Disposition )L). ja-plc) Place of Disposition c ) Oc,GkGe Rt. QV(.. /)sh fry' / /o)804 (address) // W FbRl C41/ i/ 6 N CC (section/ (lot number) (grave number) //� 8 Name of Sexton or Person in Charge of Premises n• r L7UC czP 4- Z (please print) fW Signature i ,e title S; Jr r a "k_/)ckil k DOH 1555(07/18)p i of 2 Public Health Law Sec. 4145(2b) 012948 Receipt y Human remains of f"` f .ti �,�. delivered on , 20 / Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License# CAPARELLI NAME Edward Joseph Caparelli Age: 86 Lot Owner: Edward & Christine Caparelli Lot# Horicon 11 G Grave# 1 Case: Concrete Died: 1 0 .6.2 2 Interred: 1 0.12 .22 Funeral Home: Baker FH Cemetery: Pine View CAPARELLI Lot No. 11 G Address 6 Birdsall Dr. Queensbury , NY 12804 Section No. Owner Edward & Christine Caparelli Plot Horicon Date 9/24/2010 Approx. 67 Superficial ft. @ Location Bounded on the North by Vacant , East by Williams/TenEyck, West by Snyder/Vacant and South by Gugliemo Corner Posts Remarks Deed No. (and changes) 3688 Payment Record Paid in full on (9/24/2010) $600.00) Record of Interments y�.3 . ;> I©•to• aD S N y o E / P CA T t FGiil � c �ccs-e 1\ - c�7 2 G u Pc 3 4 L X A s 6I 5 VS M .r 0 . At-AS/ TEN Eye.K A S n1 Form No. 01 E