Loading...
Dipietro, Maria J NEW YORKSTATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Maria J.Dipietro Female Date of Death Age If Veteran of U.S.Armed Forces, 03/02/2024 94 Years War or Dates Place of Death Hospital,Institution or WCity,Town or Village Johnsburg Town Street Address Elderwood at North Creek p Manner of Death X❑Natural Cause Accident ❑Homicide Suicide 111Undetermined Pending 1111 Circumstances Investigation W Medical Certifier Name Title O Wendy Steinhacker 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 11 Burial Date Cemetery,Crematory or Facility Name 03/05/2024 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York Donation ZO❑Removal Date Place Removed and/or and/or Held Hold Address 0 O. Date Point of U) Transportation p by Common Shipment Carrier Destination oDisinterment 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 H 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 03/04/2024 Registrar of Vital Statistics lean M Comstock(ECectronicalCy 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: I- W Date of Disposition 31 12'( Place of Disposition 134.0,:i7J `tfnt'ppi 2 (address) W (section) /?(rot number) (grave number) gName of Sexton or Person in Charge of Premises L •,.,.ilt Z / (pi se print) W Signature Title /f*M'(er 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#