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Puricelli, Peter M 26 ' NEW YORK STATE DEPARTMENT OF HEALTH Burial - Transit Permit Bureau of Vital Records Name First Middle Last Sex Peter M.Puricelli Male Date of Death Age If Veteran of U.S.Armed Forces, 03/16/2024 67 Years War or Dates Place of Death Hospital,Institution or Z City,Town or Village Albany Street Address St Peters Hospital W Manner of Death Undetermined Pendin W �Natural Cause Accident �Homicide �Suicide � � g Circumstances Investigation W Medical Certifier Name Title G Elizabeth Mahan PA Address 315 S Manning Blvd,Albany,New York 12208 Death Certificate Filed City Of Albany District Number Register Number City,Town or Village 0101 637 Burial Date Cemetery,Crematory or Facility Name 03/18/2024 Pine View Crematory _Entombment Address ©Cremation Queensbury Town,New York DDonation oRemoval Date Place Removed and/or and/or Held N Hold Address N❑Transportation Date Point of p by Common Shipment Carrier Destination Disinterment Date Cemetery Address Reinterment Date Cemetery Address Permit Issued to Registration Number Name of Funeral Home Regan&Denny Funeral Service 01444 Address 94 Saratoga Ave,S Glens Falls,New York 12803 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 03/18/2024 Registrar of Vital Statistics Kerry Barthotmew(ECectronicaCCy Signed) (signature/ District Number 0101 Place City Of Albany I certify that the remains of the decedent identified above were disposed of in accordance with this permit on: Z Date of Disposition Place of Disposition r -&vv".. ) - 2 (address) W CC (section) (lot number/ (grave number) SName of Sexton or Person in Cha f Premises It (p/ease prin Z V W Signature Title l��i 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# -