Menaldino, Joseph Peter NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit
Bureau of Vital Records
Name First Middle Last Sex
Joseph Peter Menaldino Male
Date of Death Age If Veteran of U.S.Armed Forces,
09/22/2023 94 Years War or Dates
F Place of Death Hospital,Institution or
Z City,Town or Village Johnsburg Town Street Address Elderwood at North Creek
pManner of Death El Natural Cause Accident 0 Homicide ESuicide Undetermined In Pending
W Circumstances Investigation
W Medical Certifier Name Title
O Kate Sauer-Jones PA
Address
112 Ski Bowl Rd,Johnsburg Town,New York 12853
Death Certificate Filed Town Of Johnsburg District Number Register Number
City,Town or Village 5655 37
L Burial Date Cemetery,Crematory or Facility Name
09/26/2023 Pine View Cemetery
Entombment
— Address
Cremation Queensbury,New York
Donation
Z Removal Date Place Removed
c and/or and/or Held
N Hold Address
0
O. Date Point of
N El Transportation Shipment
a by Common
Carrier Destination
O
Disinterment
Date Cemetery Address
0 Reinterment
Date Cemetery Address
Permit Issued to Registration Number
Name of Funeral Home Singleton Sullivan Potter Funeral Home 01596
Address
407 Bay Rd,Queensbury,New York 12804
Name of Funeral Firm Making Disposition or to Whom
H Remains are Shipped,If Other than Above
2 Address
CC
ILI
n' Permission is hereby granted to dispose of the human remains described above as indicated.
Date Issued 09/25/2023 Registrar of Vital Statistics jean IK Comstock(ECectronica(CySigned)
(signature)
District Number 5655 Place Town Of Johnsburg
I certify that the remains of the decedent identified above were disposed of in accordance with this permit on::
Z Date of Disposition q -a,,-a,, ,D- Place of Disposition ,3 1 (.ua e.l2 � L w,JU n k)J is‘...)\ �1.J f r?
UJ
2jj�� (address) 1
NCC Cal e- 3 T /
(section/ I (lot number/ I (grave number)
aName of Sexton or Person in Charge of Premises ( 7n 1 e GvedJ
Z ;leasr; ,pe pt) ,�
RISignature ��..& e. Title JI ./pe i i
DOH-1555(07/18)p 1 of 2
Public Health Law Sec.4145(2b) 012997
Receipt
Human remains of delivered on , 20
View Cemetery Representing the funeral home named on burial permit
Official Funeral Directors Reg.or License#
MENALDINO Lot No.35 I
Address PO Box 677 Glens Falls , NY 12801 Section No.
Owner Joseph Menaldino Plot Erie
Date July 21 , 2008
AQpr o x. 3.3 Superficial ft. @
Location Bounded on the North by Cudney , on East by Himes , on West by
Vacant and South by Gorleski
Corner Posts
Remarks 793-3570
Deed No. (and changes) 3561
Payment Record Paid in full on 7/21/2008 ($550.00)
Record of Interments DC iDci a.D-a
JACANT
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Form No. 01
MENALDINO
NAME Joesph Peter Menaldino Age: 94
Lot Owner: Joseph Menaldino
Lot# Erie 35 I Grave# 1
Case: Concrete
Died: 9.2 2.2 3 Interred:9 .2 6.2 3
Funeral Home: Singleton Sullivan Potter
Cemetery: Pine View