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Ross, Troy Joseph
(L4C) Zlz NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Troy Joseph Ross Male Date of Death Age If Veteran of US.Armed Forces, 03/19/2023 60 Years War or Dates i-. Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address St Peters Hospital p Manner of Death ZI Natural Cause IllAccident Homicide Suicide 1=1U Pending Circumstances Investigation WMedical Certifier Name Title C Anthony lannuccillo MD Address 315 S Manning Blvd,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 0688 Burial Date Cemetery,Crematory or Facility Name 03/22/2023 Pine View Crematory Entombment Address ©Cremation Queensbury Town,New York Donation 8❑Removal Date Place Removed and/or and/or Held ~ Hold Address 0 ilL Date Point of N Transportation s by Common Shipment Carrier Destination ElDisinterment 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 �.. Remains are Shipped,If Other than Above 2 Address CC a. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 03/22/2023 Registrar of Vital Statistics <Danieile S rjilTespie(Electronically Signed) (signature) District Number 0101 Place City Of Albany I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition 3 17 3 113 Place of Disposition Y1 2 (address) uJ CC N (section) 1 (lot number) (grave number) 8 Name of Sexton or Person in Charge of Premises 74 elkb ease print/ WSignature Title '"n� � DOH-1555(07/18)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#