Canale, Alfred UNEW YORKSTATE DEPARTMENTOF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Alfred Joseph Canale Male
Date of Death Age If Veteran of U.S.Armed Forces,
06/27/2023 67 Years War or Dates
l- Place of Death Hospital,Institution or
WCity,Town or Village Granville Village Street Address Granville Center for Rehabilitation and Nursing
p Manner of Death ❑I Natural Cause Accident Homicide Suicide nUndetermined ❑Pending
W
U I—ICircumstances Investigation
W Medical Certifier Name Title
CI Joshua Starteri NP
Address
17 Madison St,Granville Village,New York 12832
Death Certificate Filed Village Of Granville District Number Register Number
City,Town or Village 5725 26
Burial Date Cemetery,Crematory or Facility Name
06/30/2023 Pine View Cemetery
Entombment Address
Cremation Queensbury Town,New York
Donation
Date Place Removed
Removal and/or Held
H and/or
N
Hold Address
0
Date Point of
U) Transportation Shipment
Q by Common
Carrier Destination
Date Cemetery Address
Disinterment
il
Reinterment
Date Cemetery Address
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
" Address
CC
W
O. Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 06/30/2023 Registrar of Vital Statistics Diana Scarlotta(Electronically Signed)
(signature)
District Number 5725 Place Village Of Granville
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on:
F- L 1
W Date of Disposition Ca_ ,.;�.�?,Place of Disposition o f t t.� k J Q I r. (a __)Luc YlSi0c l�v Wa
2 dress)
CC CC (section/ C�� (lot number) (grave
0 Name of Sexton or Person in Charge of Premises 2cc\ Z.D �CQccti�
,(please print)
W Signaturer—teLot-d1e i Title 'u j e-t`,� - Q
DOH-1555(07/18)p 1 of 2
Public Health Law Sec. 4143(2b) u12987
Receipt
delivered on , 20
Human remains of
7
• e View Cemetery Representing the funeral home named on burial permit
fficial Funeral Directors Reg.or License# ej
I
CANALE
Owner 41:1)
Alfred CANALF / Christal Canale
Address Plot
298 Warren Rd, FT. Ann,NY 12817 Horicon
Phone # Lot #
213-247-9668 Daughter Christal Canale 30F
Deed # Date
4397 6.30.23
Cost Foundation Y - N
$800.00
Location West-Fries
North-vacant
South-Marra
East-Rozakis
Remarks
I ACKNOWLEDGE THE RECEIPT OF THE RULES AND REGULATIONS OF THE
PINE VIEW CEMETERY:
SIGNATURE: DATE:
SIGNATURE: DATE:
Record of Interments
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A
CANALE
NAME Alfred Canale Age: 67
Lot Owner: Alfred & Christal Canale
Lot# Horicon 30F Grave# 1
Case: Concrete
Died: 6.2 7.2 3 Interred:6.3 0.2 3
Funeral Home: M.B. Kilmer FH
Cemetery: Pine View