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Home My WebLink About3-59-09NameFr- �S S C of, V-� Unil 3 Bloa, 51 q Lam' 1 1 Date of Mark -ear 9 l l3 ! a Date of Buriaii / T� Timms Name of Funeral Home S ` rA IG Authorized by (Vioi 3HR5) Strunk Funeral Home - Sebastian FRANK SCOTT CAIN ( March 26, 1964 - July 08, 2020 ) Scott Cain, 56, of Roseland, Florida Fw passed away Wednesday, July 8, 2020 at Sebastian River Medical Center in Sebastian. K �� Scott was bom in Vero Beach, Florida and was a lifelong resident of the Indian River area. He loved to fish, garden, and cook. But he especially enjoyed baking. Survivors include his son Brandon Cain of Vero Beach, mother Edna E. Douglas of Roseland, father Edward Cain, Sr. of Micco, sisters Carol Frye (Ralph) of Micco, Debbie Carter of Libby, Montana and Rebecca Cain of Mount Clemons, Michigan, brothers Edward Cain, Jr. of Tampa and Mike Cain (Dawn) of Micco, stepbrother James Douglas and his wife, Beverly of Melbourne, stepsister Janet Deyette and her husband, Jeffrey of Sebastian, and his beloved granddaughter Emery Cain of Vero Beach. Scott was preceded in death by his stepfather George Elson Douglas. The family will receive friends 10 AM — 12 Noon, Tuesday, July 14, 2020 at the Strunk Funeral Home in Sebastian. A graveside service will follow at Sebastian Cemetery at 12:30 PM. Due to the Coronavims restrictions are in place for the visitation and social distancing is still in effect at the cemetery. Face coverings should be wom by all. Arrangements are by Strunk Funeral Home and Crematory, Sebastian, Florida. anOF SE�TIN HOME OF PELICAN ISLAND Certificate No. 2697 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: Edna Douglas 7935 129"' Place Roseland, FL 32957 In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lot: Unit 3, Block 59, Lot 9 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 13th day of July, 2020. CITY OF SEBASTIAN, FLORIDA ATTEST: Witt Sul E. Carlisle *3�:net�tyeWlllijams, MMC City Manager City Clerk CML, SE�TIAN HOME OF PELICAN ISLAND 1225 Main Street Sebastian, FL 32958 (772)589-5330 Phone (772)589-5570 Fax July 17, 2020 Edna Douglas 7935 129" Place Roseland, FL 32957 RE: Interment Rights to Unit 3, Block 59, Lot 9 in the Sebastian Municipal Cemetery. Dear Mrs. Douglas: Enclosed is City of Sebastian Certificate 2697 entitling you to full interment rights in Unit 3, Block 59, Lot 9 in the name Edna Douglas. If you have any questions, please contact our office at 388-8209. Sincerely, C� y sta Records Clerk Enclosure FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Kip Kelso, .Cemetery Sexton F X Sebastian Municipal Cemetery � ID _ yr Phone: (772) 589-2545 (j Fax: (772) 228-9927 +� City Clerk's Office — Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or388.8214 ctesta5citvofsebastian.oro FUNERAL HOME: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian. Florida, 32958 PHONE#: 772-589-1000 (Check One) XM2j OPEN BURIAL LOT _OPEN CREMAINS LOT _OPEN COLUMBARIUM NICHE Lot 9 Block 59 Unit 3 Lot -Block -Unit Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: 12:30 PM, Tuesday, 7/14/2020 at Sebastian Cemetery FOR DECEASED: Frank ScottCain - SQ J Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Edna E. Doualas Edwa E. DOL AI.aS 7/10/2020 Name P-o 90 10116 905"AW:) � Signature Date 7935129th Place, Roseland, Florida, 32957 I certify that I have determined the ownership of the above described site that all site fees and administrative fees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: Marshall Voyles Name MatsRa@@ Nog@es 7/10/2020 Signature Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: Cemetery Sexton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. mr Q S[BAS AN � ao"I I /�I HOME Or PELICAN ISLAND 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 and person for whom lot is intended for interment must be provided at time of purchase. 1r_-DrJA bnUG A5 Name(s) n NkA,(U-To : ?o. t3Ox )ore Kusec_ .t , CL 3aq'5-1 Address Ailnoess : -7q 35' ldF`YA R.-,c-e K,a1e Laurel FL 3a9,�57 Area Code & Phone NumberK S. Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: o 6V-SA,JD A,-J o0)100 ---- Dollars ($ on this 1-3 day of -1 ul� Cemetery Lot(s) and/or Niche(s). Unit 3 Block 59 , Lot(s) 20do for the purchase of the following described 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 Corner Markers (set of 4 - $20) Opening & Closing �• / w O H Circle One Vase and Ring for Niches (cost) Interment Disinterment Temporary Marker Preparation & Installation TOTA no RL .nlL Signature of Purchaser City of Seb_at The following documents were provided as Proof of Residency: 1:1WW-DATA\Ms-C.etery\RECEIPT.dw __, CITY OF SEBASTIAN 12550 ADMINISTRATIVE SERVICES RECEIPT Name.' iIAIAS /0r ', ❑Cash Date `7'l3'a0a0 Ij Oheck# /dbS O Credit Amount Paid 001501 362150 Non -Taxable Rent 001001 220000 Security Deposit 001501 362100 Taxable Rent 001001208001 Sales Tax 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 220030 PD SHOP 001501366602 PD SAFE 001501 366603 PD COPE �.b (cOIOIO ?��F35r1 LOT Y! 0a.000.od Ntt 3 LOCK6q Lbr 9 Total PidiCOb. Ge Initials White - Dept. of Origin - Yellow - Admin. Svcs. • Pink -Applicant CITY OF SEBASTIAN 12552 ADMINISTRATIVE SERVICES RECEIPT Name�LLlt Fes' �%a, �! ❑Cash Date 7-13'IWAO VCheck# f6bZ 0 Credit Amount Paid 001501 362150 Non -Taxable Rent 001001 220000 Security Deposit 001501 362100 Taxable Rent 001001208001 Sales Tax 450010 369900 Airport Badge 001001 218010 CobraServe 001501 354100 Code Enforcement Fines 001501347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 220030 PD SHOP 001501366602 PD SAFE 001501 366603 PD COPE DO 1 SOI Ada k5 OIr . Sl p• it 3 tocy59 Lar 4 Total A ��• 00 Initials White - Dept. of Origin • Yellow - Admin. Svcs. - Pink -Applicant State of Florida, Department of Health, Bureau of Vital Statistics O� BURIAL TRANSIT PERMIT HEALTH DATE PRINTED: July 10, 2020 TRACKING NUMBER: 2020121627 1. DECEDENT INFORMATION Name of Deceased Data of Death FRANK SCOTT CAIN July a, 2020 Place of Death. County City, Town or Location Name of facility, or street address if net a facility INDIAN RIVER SEBASTIAN SEBASTIAN RIVER MEDICAL CENTER Name and Add. of Funeral HumelDirem Disposal Establishment Fla. Dc. NoJRsg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN FN1870 FNI870 (772)589-1000 1623 N CENTRALAVE SEBASTIAN, FLORIDA. 32958 Funeral Oirec[oNDlrem Disposer Fla. L.Ic. NoJReg. No. ROBERT M. VOYLES JR F043486 finding verification Statement MICHELLE atthe certifying physician's office, was contacted on 07/0912020 by the funeral director listed Stave; helshe Indicated Nat VIKASH PRIYADARSHI, certifying physician, will Complete and sign the medical certifica ion of cause of death within 72 hours. 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2020-F041670-5007 Date Issued: July g, 2020 State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number. 4. CEMETERY OR CREMATORY,,,,,,,, Place of Disposition: SESASTUN CEMETERY I to,vs I14ILL//2I-y-11/) Method of Disposition: BURIAL Date of Disposig I EDRS maintains all statutorily required Information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10112 64V-1.011. FImMa Administrative Code 12/01/2020 2:08 Pa FAX 7725892583 STRUNK ® oaav0001 CITY OF HOME OF PELICAN ISLAND Sebastian Cemetery Ph# 772-589-2545 Fax# 772-228-9927 Site Plan for Marker Installation Funeral Home; _STRUNK FUNERAL HOME & CREMATORY 1623 NORTH CENTRAL AVENUE, SEBASTIAN, FLORIDA 32958 Type &Size of Marker: Z-dK D-(o n 2-/V 5.0 X 1-0 XD-(0 His His NK GCD I 1 CN1 Hers DOB: 3 I IV I I LVL{ I DOB: / DOD: 7 I 'b I ?O2-D DOD: 3 Unit: Unit: Block: e�"I Blac . Size Foundation Material 1' x 2%............................................ Dry mix, consisting of a bag of concrete (only) includes flat grass marker. Larger than I' x 2................................Formed and poured concrete including base. Approved by: f GAi. r'- Marked out by: Date z Foundation Poured by: S-rf�A%< Date I — t'3— 01 Foundation Material gcs c Date