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Tesiero-Esposito, Kathleen 14- 3-)i NEW YORKSTATE DEPARTMENT OF HEALTH • - Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Kathleen Tesiero-Esposito Female Date of Death Age If Veteran of U.S.Armed Forces, 04/22/2023 52 Years War or Dates H Place of Death Hospital,Institution or WCity,Town or Village Corinth Town Street Address 45 Eggleston Street,Corinth Town,New York 12822 0 Manner of Death gi Natural Cause Accident 0 Homicide OSuicide FlUndetermined Pending W Circumstances Investigation W Medical Certifier Name Title 0 David DeCelle Coroner Address 40 McMaster Street,Ballston Spa,New York 12020 Death Certificate Filed Town Of Corinth District Number Register Number City,Town or Village 4553 7 Burial Date Cemetery,Crematory or Facility Name 04/25/2023 Pineview Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation ElRemoval Date Place Removed and/or and/or Held NHold Address 0 O. Date Point of CO❑Transportation Shipment p by Common Carrier Destination ElDisinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom H Remains are Shipped,If Other than Above 2 Address cc W 0. Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 04/23/2023 Registrar of Vital Statistics Brenda L Penis(Electronically Signed) /signature/ District Number 4553 Place Town Of Corinth I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: 7 W Date of Disposition q ilT I l 3 Place of Disposition -FA__ 2 (address) W +lntr (section) (lot number) E tt (gave number) 8 Name of Sexton or Person in Charge of Premises . � z /pase print) ILISignature • Title fivfreifireZ DOH-1555(o7/18)p t 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#