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Sabo Jr., Antonius Nicholas 1...Ckl , 41- trio NEW YORK STATE DEPARTMENT OF HEALTH © Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Antonius Nicholas Sabo Jr. Male Date of Death Age If Veteran of U.S.Armed Forces, 05/10/2023 74 Years War or Dates 1969-1973 ' H Place of Death Hospital,Institution or WCity,Town or Village Glens Falls Street Address Glens Falls Hospital pManner of Death ❑X Natural Cause IllAccident []Homicide Suicide IllUndetermined ❑Pending U Circumstances Investigation d Medical Certifier Name Title Sue Badera NP Address 41 Grand Street,Glens Falls,New York 12801 Death Certificate Filed City Of Glens Falls District Number Register Number City,Town or Village 5601 250 EdBurial Date Cemetery,Crematory or Facility Name 05/15/2023 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation Z Date Place Removed Removal and/or Held I - and/or N Hold Address 0 n. Date Point of U)❑Transportation p by Common Shipment Carrier Destination ODisinterment Date Cemetery Address EiReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Carleton Funeral Home Inc 00281 Address 68 Main Street,P.O.Box 67,Hudson Falls,New York 12839 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 05/15/2023 Registrar of Vital Statistics 7KeganWolin(ElectronicalTySigned) (signature) District Number 5601 Place City Of Glens Falls I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: I— W Date of Disposition ,5--/(�-4i?3 Place of Disposition 7tn j' aet„� e fe im 2 (address) W Cl)CC (section) (lot numb r) (grave number) 0 Name of Sexton or Person in Charge of Premises 1C (�it0r'') (--) (please print) W Signature Z g l� Title 0(Gra, DOH-1555(07/18)p 1 of 2 Public Health Law Sec. 4145(2b) Receipt Human remains of delivered on 1 , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg.or License#