HomeMy WebLinkAbout3-COL-37DnBCITY of
SIEBASTLAN,
HOME OF PELICAN ISLAND
Certificate No. 2940
xOf SEBASTIAN
'
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Myriam A. de los Hoyos
25 Plantation Drive Apt #104
Vero Beach, Florida 32966
In and for consideration of the sum of $4,800.00 is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Col, Niche 37DnB
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 17th day of May, 2024.
CITY OF SEBASTIAN, FLORIDA
Brian Ben
City Manager
ATTEST:
/anette Williams, MMC
City Clerk
ancF
SEBAMkN
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772)589-5330 Phone
(772) 589-5570 Fax
May 22, 2024
Myriam A. de los Hoyos
25 Plantation Drive Apt #104
Vero Beach, FL 32966
RE: Interment Rights to Unit 3, Col, Niche 37Dn8 in the Sebastian Municipal Cemetery.
Dear Mrs. de los Hoyos,
Enclosed is City of Sebastian Certificate 2940 entitling you to full interment rights in
Unit 3, Col, Niche 37DnB in the name Myriam A. de los Hoyos.
If you have any questions, please contact our office at 388-8209.
Sinc��er��ely,
Cathy Testa
Records Specialist
Enclosure
MYor
46
HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, FL 32958 772-388-8209
City of Sebastian Municipal Cemetery Purchase Order
Name(s) AIDS 4610S
025 FIAr�.J-2�_rton �2�Je �T � 1 �`i'
Address
Area Code & Phone Number
-i7� �69 ail � F2a�k clelas
Name & Residence Address of Intended Occupant if Other Than Purchaser I S
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
F�lc� thlwsc '0-tp C)r-'/too Dollars ($ L�/?C'(�,0c,
on this day of 20.� + for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit 3 Block (OL— Lot(s) Niche(s)
for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed
therefore by the City of Sebastian.
Additional Fees Paid at time of purchase:
Opening & Closing fee for ceremony after hours or on holiday. $
Disinterment Fee $
TOTAL $ `i", q 60• '
Sigg r= rc� '
L
City oSstia
CITY OF SEBASTIAN 15768
ADMINISTRATIVE SERVICES RECEIPT
Name / vS ❑Cash
Date 5-4i1 a 4 yCheck # A(. 6- S
O Credit
Amount Paid
001501 362150
Non -Taxable Rent
001001 220000
Security Deposit
001501 362100
Taxable Rent
001001 208001
Sales Tax
450010 369900
Airport Badge
450010 362521
AP Shade Hangar Rent
450001 208045
Airport Sales Tax
001501 347557
Community Center Revenue
001501 341920
General Fund Copies
001501 354100
Code Enforcement Fines
001001 220030
PD Shop with a Cop
001001220033
PD COPE
001001 220032
PD Explorer
010043 535270
PD Uniforms
g00' W
601010 343800
Cemetery Lot Sales 7
001501 343805
Cemetery Fees
480010 341920
Bldg Dept Copies
l )o,3('c)V 37iIN6
Total Paid DO
Initials
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant
CITY Lf
SEAT,
HOME OF PELICAN ISLAND
CITY/ OF SE—B—-STIAAV1
Cemetery Certificate
THIS INDENTURE MADE this 5th day of April, 2024, between Lyn E. Simmons, 530
Persimmon Drive Barefoot Bay, FL 32976 and the City of Sebastian, a municipal
corporation existing under the law of the State of Florida of the County of Indian River,
State of Florida as Grantee, WITNESSETH:
That the Grantor for and in consideration of the sum of $4000.00 to be mailed
minus a 15% administrative fee, the receipt where of is herewith acknowledged, does by
this instrument grant, bargain, sell, release, convey and confirm unto the Grantee their
legal representatives and assigns the following property situated in the City of
Sebastian, Indian River County, Florida, to wit:
All of Unit 3 Columbarium Niche 37DnB of the Sebastian Municipal Cemetery as
maintained on file in the records of the City Clerk.
To have and hold the same forever; in fee simple.
IN WITNESS WHEREOF, the said party of the first part has caused this instrument
to be executed in their name and witnessed the day and year first above written.
By:
W itnessl:L/��
STATE OF FLOre 10,4
COUNTY OF /nit>,A,4 KtVsiN-
The foregoing instrument was acknowledged before me X in person orvia electronic
� means this 5 day of ?1L ,o�'-N , by i-\/n/ Snnt�nS , who is personally
known to me or who has produced D12I1/ek5 License -as identification and who did —or
did not�C take an oath
STAMP OR SEAL:
"".. CATHERINE E. TESTA
Commission # HH 054261
- ;P 'Expires February 16, 2025
•^Fo:i?: Boded Tire Troy Fain Insurance M385-7019
X r �-
Notary Public, tie of Florida
My ommission expires on:
f�Ry fro, Zo25
cm OF
SEBAST"
ars
HOME OF PELICAN ISLAND
Certificate No. 2517
CITE OF SE$ STIAN
Certificate of Interment Ric
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Lyn E. Simmons
530 Persimmon Drive
Barefoot Bay, FL 32976
In and for consideration of the sum of $4,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3; Columbarium, Niche 37DnB
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED,THIS 12th day of September, 2016.
CITY OF-'SEBASTIAN, FLORIDA ATTEST:
Joseph F. Griffin 4eanette william,S, MMC
City Manager City Clerk
CITY OF SEBASTIAN 15749
ADMINISTRATIVE SERVICES RECEIPT
Name Slirnrno s
Date I
b t s- i n4-e.Cr MtyVL
❑ Cash
w Check # ! GO
❑ Credit
001501 362150 Non -Taxable Rent
001001 220000 Security Deposit
001501 362100 Taxable Rent
001001 208001 Sales Tax
450010 369900 Airport Badge
450010 362521 AP Shade Hangar Rent
450001 208045 Airport Sales Tax
001501 347557 Community Center Revenue
001501 341920 General Fund Copies
001501 354100 Code Enforcement Fines
001001 220030 PD Shop with a Cop
001001220033 PD COPE
001001 220032 PD Explorer
010043 535270 PD Uniforms
601010 343800 Cemetery Lot Sales
001501 343805 Cemetery Fees
480010 341920 Bldg Dept Copies
Amount Paid
'T !yy, 00
IT) 3 &I.-, 3I N9 Total Pai�1��qd !15D �/1
• Ce)
Initials
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant
Name �G r-te
Unit
Block
Lot 7-7 O l N l 6
Date of Mark -out
Date of Burial
S� 120 l ay
�;, r 20 �y
Name of Furneral Home ' C,
Authorized by
/J"
rAEIv: ,n S , mr-tG,RS C.rcna;,
James Simmons Obituary
James "Jim" Melvin Simmons, 75, of Barefoot Bay,
FL, formally of Ferndale, MD, passed away on
Sunday August 21, 2016, with his family by his
side. After Jim's service to our country in the
United States Air Force, he continued his career
with the Department of Defense. Jim is survived by
his wife of 52 years, Lyn E. Simmons (nee Fuhrer);
sister, Sharon A. Waddill; sons, Michael and wife
Angela; Jeffrey and wife Tysa; grandchildren,
Anthony and wife Josie, Mackenzie, Cole, Emily,
Jaelyn and Ryan; great-grandchildren, Milla and
Mikaela; sister in law, Verne, her husband Gus and
family.
Published by Baltimore Sun on Aug. 25, 2016.
SEAWINDS CREMATORY
Sebastian, Florida
735 Fleming Street • Sebastian, Florida 32958
www.seawindsfh.com
(772) 589-1933
We hereby certify that these are the remains of JAMES MELVIN SIMMONS
# t7;! �L'
.. The remains were received
from SEAWINDS FUNERAL HOME & CREMATORY
Cremation Permit No. 16-73380-5 193
Date of Death AUGUST 21, 2016
Date of Cremation r .4P 6-0 � 14V
Issued at BREVARD COUNTY
By 41K� O*eA
Cremator
CITY OF SEBASTIAN 15474
ADMINISTRATIVE SERVICES RECEIPT
Name ,1 IU M r NI-S
Date Q I 1 b 134
❑ Cash
r `check # /y�
❑ Credit
001501 362150 Non -Taxable Rent
001001 220000 Security Deposit
001501 362100 Taxable Rent
001001 208001 Sales Tax
450010 369900 Airport Badge
450010 362521 AP Shade Hangar Rent
450001 208045 Airport Sales Tax
001501 347557 Community Center Revenue
001501 341920 General Fund Copies
001501 354100 Code Enforcement Fines
001001 220030 PD Shop with a Cop
001001 220033 PD COPE
001001 220032 PD Explorer
010043 535270 PD Uniforms
601010 343800 Cemetery Lot Sales
001501 343805 Cemetery Fees
480010 341920 Bldg Dept Copies
Amount Paid
I Sb C10
L)M1-f_3 6L(X,)-00L -3-1>r\h �
l 7A Total Paid /50
Initials % --j
White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant
anQ*
iBASTUV**j
iw
HOME OF PELICAN ISLAND
1225 Main Street
Sebastian, FL 32958
(772) 589-5330 Phone
(772) 589-5570 Fax
September 20, 2016
Lyn E. Simmons
530 Persimmon Drive
Barefoot Bay, FL 32976
RE: Interment Rights to Unit 3, Columbarium, Niche 37DnB Sebastian Municipal
Cemetery
Dear Ms. Simmons,
Enclosed is City of Sebastian Certificate 2517 entitling you to full interment rights in
Unit 3, Columbarium, Niche 37 DnB in the name of Lyn E. Simmons.
If you have any questions, please contact our office at 388-8209.
Sincerely,
S�6
Cathy Ttysta
Records Clerk
Enclosure
HOME OF PELICAN ISLAND
Certificate No. 2517
CITY OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Lyn E. Simmons
530 Persimmon Drive
Barefoot Bay, FL 32976
In and for consideration of the sum of $4,000.00 is entitled to full interment
rights in the Sebastian Municipal Cemetery for the following niche:
Unit 3, Columbarium, Niche 37DnB
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 12th day of September, 2016.
CITY OF SEBASTIAN, FLORIDA
Joseph F. Griffin
City Manager
ATTEST:
4 eanette Williams; MMC
City Clerk _
City of Sebastian Municipal Cemetery Purchase Receipt
To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate
regulations, proof of City residency of purchaser or person for whom lot is intended for interment must
be provided at time of purchase.
Name(s)
5 Pe As V[4 W 1DVL -orL 3 A g _7*
Address �
Area Code & Phone Number
Name & Residence Address of Intended Occupant if Other Than Purchaser
OFFICE USE ONLY
Receipt is acknowledged in the sum of:
�t2 `o)� oo t c�a Dollars($ 4-,00D.00)
on this IA4"\ day of A;,e ., 20 )b for the purchase of the following described
Cemetery Lot(s) and/or Niche(s).
Unit --'? , Block 001, , Lot(s)
Niche(s) 37 b,v,6
for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed
therefore by the City of Sebastian.
Additional Fees paid at time of purchase:
Corner Markers (set of 4 - $20) Opening & Closing
Vase and Ring for Niches (cost) a'T zo Interment
Temporary Marker Preparation & Installation
'gnatGre of Purchaser
/W O H
Circle One
Disinterment
TOTAL $--f4o gq-, a S
City of Sebastian
The following documents were provided as Proof of
Residency:
I:IWW-DATA\Ms-Cemetery\RECEIPT.doc and
PLEASE PRINT
DECEASEL)
ti'AN-IF: J& m e,
(Middle)
DATE OF ISIR'I*tl:____..___.
(Month) (Day)
5imemons
(Last)
(Ymr)
DATE 01-AWATH: _. _ _....._ ....., __ ..._... __......__. ._ _ . __°c' 0 i � _.___ __..._._ . _ ._.
Month) (Day) (Year)
PRINT
DATE: A /02 (Mo
FOR OFFICE USE ONLY
I nit 3
Double !North I B
COIX MUE. RII-JIM:
(NORTH)
PIA'.ASE PRINT
N AN -I F,: E LLen---
0, 3 s 0 (Middle)
DATE OF
(Month) (Day)
v !I-mpn-5
(Last)
DATE 01DEATIL
(Month) (Day) (Year)
SI(;NAITRF-:.-Cx
PIUNT
SIGNAITAE:
FOR OFFICE USE ONLY
I nit 3
Double I North I B
7.-01
(NORTH)
NICH B 7
IN (JIM I 11: 1
CITY OF SEBASTIAN 10378
ADMINISTRATIVE SERVICES RECEIPT
Name ❑ Cash
Date `� j�--6 Check #
0 Credit
Amount Paid
001001 208001 Sales Tax
001001 220000 Security Deposit
001501 362100 Taxable Rent
001501 362150 Non -Taxable Rent
450010 369900 Airport Badge
001001218010 CobraServe
001501 354100 Code Enforcement Fines
001501 347557 Community Center Revenue
001501341920 Copies
001501 351140 Parking Citation
001501 342100 Police Security Services
001501 329200 Site Plan Review
001501 329300 Subdivision/Plat Review
001501 329100 Zoning Fees
001501 35�O-s 4 A�S-
4"4 00 0 . no
yl/b aS
Total Pal j#4�02 q.
Oals
Security Dep Held - Amount $ Check #
White - Dept. of Origin - Yellow - Admin. Svcs. • Pink - Applicant