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Mosca, George J Sr.
, .. - #1 Cri NEW YORK STATE DEPARTMENT OF HEALTH v Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex George J Mosca Sr Male Date of Death Age If Veteran of U.S.Armed Forces, 02/24/2024 82 Years War or Dates l„., Place of Death Hospital,Institution or WCity,Town or Village Saratoga Springs Street Address Saratoga Hospital 0 Manner of Death IZI Natural Cause ❑Accident 0 Homicide nSuicide Undetermined ❑Pending ILI C)) Circumstances Investigation 0 Medical Certifier Name Title Kevin Dooley MD 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 123 Burial Date Cemetery,Crematory or Facility Name 02/27/2024 Pineview Crematory Entombment _ Address ©Cremation Queensbury Town,New York Donation ❑Removal Date Place Removed i• and/or and/or Held N Hold Address 0 LL Date Point of U)OTransportation p by Common Shipment Carrier Destination Disinterment Date Cemetery Address ElReinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Densmore Funeral Home Inc 00448 Address 7 Sherman Ave,Corinth,New York 12822 Name of Funeral Firm Making Disposition or to Whom F.. Remains are Shipped,If Other than Above 2 Address fr W n' Permission is hereby granted to dispose of the human remains described above as indicated. Date Issued 02/26/2024 Registrar of Vital Statistics Dillon Moran(Electronically Signer (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: I— W Date of Disposition 2l n(7i Place of Disposition -.rNEvi-6 u C i i AT'G;:C�ti. 2 (address) tu CCSignature (section) /tot number) (grave number) 0 Name of Sexton or Person in Charge of Premises (/�9 \ wr'itf Z ease primW C-X Title (RN r�I Jq 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#