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Spizzo, Anthony tt Ligl ..: (1D NEW YORK STATE DEPARTMENT OF H EALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Anthony Spizzo Male Date of Death Age If Veteran of U.S.Armed Forces, 06/10/2023 93 Years War or Dates 1947-1951 l„_ Place of Death Hospital,Institution or Z City,Town or Village Poughkeepsie Street Address Vassar Brothers Medical Center 111 p Manner of Death El Natural Cause Accident n Homicide lilSuicide Undetermined Pending W C.) Circumstances Investigation W Medical Certifier Name Title CI Delysa Owens NP Address 45 Reade PI,Poughkeepsie,New York 12601 Death Certificate Filed City Of Poughkeepsie District Number Register Number City,Town or Village 1302 485 Burial Date Cemetery,Crematory or Facility Name 06/13/2023 Pine View Crematory Entombment ©Cremation Queensbury Town,New York Donation 0❑Removal Date Place Removed and/or and/or Held H Hold Address CO 0 El Transportation Date Point of by Common Shipment Carrier Destination Date Cemetery Address nDisinterment Date Cemetery Address C Reinterment Permit Issued to Registration Number Name of Funeral Home M B Kilmer Funeral Home-South Glens Falls 01078 Address 136 Main St,S Glens Falls,New York 12803 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above i Address CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 06/12/2023 Registrar of Vital Statistics Catltenne)?Sctiolette(TYectronicat7 S#nea)' (signature) District Number 1302 Place City Of Poughkeepsie I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: H (1 Z Date of Disposition (4,113 11; Place of Disposition Fy,9_ 2 (address) W Cl) (section) (lot number) (grave number) 0 C GName of Sexton or Person in Charge of Pr i s ^ H Z (please print) tL Signature Title ` (Zio�j�� 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#