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Maiorana, Eugene F
F - NEWYORKSTATEDEPARTMENTOFHEALTH Bureau of Vital Records BurialTransit 1/13 Permit Name First Middle Last Sex Eugene F.Maiorana Male Date of Death Age If Veteran of U.S.Armed Forces, 01/09/2024 83 Years War or Dates .. Place of Death Hospital,Institution or Z City,Town or Village Johnsburg Town Street Address 195 School House Road,Johnsburg Town,New York 12856 pManner of Death Natural Cause Accident Homicide Suicide Undetermined Pending Circumstances Investigation WMedical Certifier Name Title Ellen Deprey PA Address 9 Carey Road,Queensbury Town, New York 12804 Death Certificate Filed Town Of Johnsburg District Number Register Number City,Town or Village 5655 2 Burial Date Cemetery,Crematory or Facility Name 01/11/2024 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York Donation Z Date Place Removed 2❑Removal and/or and/or Held N Hold Address 0 CL Date Point of (I) Transportation CI Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Alexander Baker Funeral Home 00037 Address 3809 Main St,Warrensburg,New York 12885 Name of Funeral Firm Making Disposition or to Whom 1— Remains are Shipped,If Other than Above 2— Address -- CC W a Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 01/10/2024 Registrar of Vital Statistics jean M Comstock(ECectronicaCCy Signed) (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 l II I 12' Place of Disposition ItIEv J oviyirr W (address) W llY (section) (lot number) (grave number) O Name of Sexton or Person in Charge of Premises ' v� it -,-+ (plIee print) W ri*Signature [/ ' Title ►'�'�•4 tV Z. DOH-1555(07/18)p t of 2 � N -4 I 7 Q j 7 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#