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Agostini, Angel Alex 1.110F - NEW YORK STATE DEPARTMENT OF HEALTH Bureau of Vital Records Burial Transit Permit Name First Middle Last Sex Angel Alex Agostini Male Date of Death Age If Veteran of U.S.Armed Forces, 01/17/2024 70 Years War or Dates 2 s— Place of Death Hospital,Institution or Z City,Town or Village Saratoga Springs Street Address Saratoga Hospital W Manner of Death Undetermined Pending W Natural Cause Accident Homicide Suicide Circumstances Investigation W Medical Certifier Name Title 0 Maria Vivenzio DO Address 211 Church St,Saratoga Springs,New York 12866 Death Certificate Filed City Of Saratoga Springs District Number Register Number City,Town or Village 4501 41 Burial Date Cemetery,Crematory or Facility Name IIIMINII 01/22/2024 Pine View Crematorium Entombment Address ©Cremation Queensbury Town,New York Donation OZ❑Removal Date Place Removed and/or and/or Held H Hold Address O d Date Point of V) Transportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment 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 Remains are Shipped,If Other than Above 2 Address CC W • Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/22/2024 Registrar of Vital Statistics Afton Moran(ECectronica1Ty Signed) (signature) District Number 4501 Place City Of Saratoga Springs I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition ( 11 if 1111 Place of Disposition FT,iEvr61/4, rj r v UJ 2 (address) W N CC (section) 71.P1 (lot numb (grave number) 0 Name of Sexton or Person in Charrego Premises ;irr /% lease print)W /I Signature Title ` YZ/Z DOH-1555(07/18)p t of 2 Public Health Law Sec. 4145(2b) `; 17882 Receipt Human remains of delivered on , 20 Pine View Cemetery Representing the funeral home named on burial permit Official Funeral Directors Reg. or License#--