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NEW YORKSTATE DEPARTMENT �`�
OF HEALTH Burial of Vital Records - Transit Permit
Name First Middle Last Sex
Joseph O.Castro Male
Date of Death Age If Veteran of U.S.Armed Forces,
01/17/2023 48 Years War or Dates
Place of Death Hospital,Institution or
Z City,Town or Village Moreau Town Street Address Route 9 and Spier Falls Road,Moreau Town,New York 12831
Ili
p Manner of Death Natural Cause ❑Accident Homicide Suicide Undetermined Pending
V Circumstances Investigation
0ILI Medical Certifier Name Title
David DeCelle Coroner
Address
40 McMaster Street,Ballston Spa,New York 12020
Death Certificate Filed Town Of Moreau District Number • I Register Number —
City,Town or Village 4562 u 3 J
Burial Date Cemetery,Crematory or Facility Name
01/20/2023 Pine View Crematorium
Entombment Address
Cremation Queensbury Town,New York
Donation
ZO❑Removal Date Place Removed
and/or and/or Held
N Hold Address
0
O. Date Point of
U')DTransportation
a by Common Shipment
Carrier Destination
Date Cemetery Address
❑Disinterment
Reinterment Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Barton-Mcdermott Funeral Home Inc 00141
Address
9 Pine St,Chestertown,New York 12817
Name of Funeral Firm Making Disposition or to Whom
1.— Remains are Shipped,If Other than Above
2 Address
CC
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a' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 01/19/2023 Registrar of Vital Statistics Leeann licCa6e(ECectronicaQySigned)
(signature)
District Number 4562 Place Town Of Moreau
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
Date of Disposition I I2o(Z3 Place of Disposition r!.sari___
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2 (address)
W
re (section) (lot number) (grave number)
SName of Sexton or Person in Charge of Premises /L1 �. �'14.�,41
Z /ease print)
W Signature Title (Wig)►�
DOH-1555(07/18)p i 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..perinit
Official Funeral Directors Reg.or License#