Corti, John Joseph Li
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NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
John Joseph Corti Male
Date of Death Age If Veteran of U.S.Armed Forces,
09/05/2022 74 Years War or Dates 1967-1970
Place of Death Hospital,Institution or
Z. City,Town or Village Glens Falls Street Address 7 Taylor Street,Glens Falls,New York 12801
111
13 Manner of Death ❑X Natural Cause IllAccident 0 Homicide ESuicide Undetermined ❑Pending
ILI
Circumstances Investigation
UI Medical Certifier Name Title
0 Curtis Gedney MD
Address
454 Glen Street,Glens Falls,New York 12801
Death Certificate Filed City Of Glens Falls District Number Register Number
City,Town or Village 5601 454
Burial Date Cemetery,Crematory or Facility Name
09/06/2022 Pine View Crematory
Entombment Address
Cremation Queensbury Town,New York
IDDonation
Removal Date Place Removed
°b and/or Held
p and/or
Hold Address
EL Date Point of
tPt Transportation
p by Common Shipment
Carrier Destination
❑Disinterment
Date Cemetery Address
Date Cemetery Address
Reinterment
Permit Issued to Registration Number
Name of Funeral Home M B Kilmer Funeral Home-Fort Edward 01079
Address
82 Broadway,Fort Edward,New York 12828
Name of Funeral Firm Making Disposition or to Whom
1— Remains are Shipped,If Other than Above
g Address
Et
Di
IL
Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/06/2022 Registrar of Vital Statistics MeganNolin(EfectronicalTySigned)
(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 Z---..._,
Date of Disposition et I$)1Z Place of Disposition IA_V
2. /address)
W
CC (section) Allot
number) (grave number)
0 �+4 rt
a Name of Sexton or Person in Chademises
n
/p a print)
'U 641�i2
Signature Title
DOH-1555(o7/18)p 1 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#