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Rocco, Anthony J
- # 34D NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Anthony J Rocco Male Date of Death Age If Veteran of U.S.Armed Forces, 04/24/2023 53 Years War or Dates F. Place of Death Hospital,Institution or Z City,Town or Village Ballston Spa Village Street Address 91 Church Avenue 318,Ballston Spa Village,New York 12020 ILI p Manner of Death 0 Natural Cause Accident Homicide []Suicide []Undetermined []Pending W I 1Circumstances ' !Investigation U uJ Medical Certifier Name Title CI David DeCelle Coroner Address 40 McMaster Street,Ballston Spa,New York 12020 Death Certificate Filed Village Of Ballston Spa District Number Register Number City,Town or Village 4520 8 Burial Date Cemetery,Crematory or Facility Name 04/28/2023 Pine View Cemetery and Crematorium []Entombment Address ©Cremation Queensbury Town,New York []Donation 0❑Removal Date Place Removed - and/or and/or Held t—- Hold Address N 0 d Date Point of • N❑Transportation Shipment p by Common Carrier Destination Date Cemetery Address []Disinterment EIReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home William J Burke&Sons Funeral Home 01827 Address 628 N Broadway,Saratoga Springs,New York 12866 Name of Funeral Firm Making Disposition or to Whom i— Remains are Shipped,If Other than Above Address CC WI 0-Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/27/2023 Registrar of Vital Statistics Teti Lee OConnorgYectronicalySigned) (signature) District Number 4520 Place Village Of Ballston Spa I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition if ft',(73 Place of Disposition ?L.-AL /'I--_ 2 (address) Ui CCCC (section) ii (lot number) (grave number) 0 Name of Sexton or Person in Charge of Premises " L- &,,N,Iii Z �f (pie print) lL Signature �/� Title lRCY»�l tif DOH-1555(07/18)p 1 of 2 /`� - - ' ra Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on , 20 e View Cemetery Representing the funeral home named on burial permit Funeral Directors Reg.or License#