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Home My WebLink About3-14-08State of Florida, Department of Health, Bureau of Vital Statistics BURIAL TRANSIT PERMIT NMTH DATE PRINTED: November 4, 2025 TRACKING NUMBER: 2025199099 1. DECEDENT INFORMATION Name of Deceased Date of Death HERIBERTO GAMEZ GUTIERREZ October 30, 2025 Place of Death - County City, Town or Location Name of facility, or street address if not a facility HILLSBOROUGH TAMPA TAMPA GENERAL HOSPITAL Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No./Reg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 Funeral Director/Direct Disposer Fla. Lic. No./Reg. No. SANDRA ASSUNTA MASTRANDO F764131 Medical Verification Statement Lisa Patterson at the certifying physician's office, was contacted on 1110312025 by the funeral director listed above; he/she Indicated that CUC THI MAI, certifying physician, will complete and sign the medical certification 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: 2025-FO41870-5153 Date Issued' November 3, 2025 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: SEBASTIAN CEMETERY Method of Disposition: BURIAL Date of Disposition: 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. Florida Administrative Code Funeral Director's Request to City of Sebastian for Burial Opening in Sebastian Municipal Cemetery Contact Information: City Clerk's Office Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Phone (772) 388-8209 ctestxritcitvolsehastian.ore Funeral Home: Strunk Funeral Home Address:1623 N. central Ave, Sebastian FI 32958 Phone:772-589-1000 (Check) _Open Burial Lot Open Cremains Lot Open Columbarium Niche Burial Date and Service Time: Thursday 11/6 1:15Pm Deceased Name: Heriberto Gamez Unit Block14 LotB Unit_ Block_ Lot_ Unit Block Niche Name and Signature of Lot Owner or Representative: (Must provide proper documentation of ownership) Print Name Signature Date Address Phone Number 1 certify that I have determined the ners 'p of the above -described site that all site fees and administrative fees have been pai onze o ing of same. Name and Signature of L' se Fu irector: Sandy Mastrando 11/3/2025 Print Name / /i Date I certify that 1 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 Certification: Cemetery Date This form is to be provided to Clerk's Office for permanent record upon completion. MyOf SIE HOME OF PELICAN ISLAND 1225 Main Street, Sebastian, FL 32958 772-388-8209 City of Sebastian Municipal Cemetery Purchase Order I jna Ciarn-e2 Ciarn�z 2 �(� S- FL) 32-q,4V Address 77Z-5y9- 0000 Area Code & Phone Number 14 e n he0v d' arne2 Name & Residence Ad ress of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: ��toaS�nd Q(q�f hun6tred. trC4Dollars ($ 7 V50.60) J on this day of , 20 for the purchase of the following described Cemetery Lot(s) and/or Niche(s). Unit 3 Block 12-1 Lot(s) k 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 ourchase: Opening & Closing fee for ceremony after hours or on holiday. $ Disinterment Fee $ TOTAL $ 2 � 5 0 (' C'-% Signature of Purchaser ity, of Sebastian oTY0F SE�T�V HOME OF PELICAN ISLAND Sebastian Municipal Cemetery Artificial and fresh flower, blankets. No more than two bouquets of artificial or fresh flowers will be allowed at any gravesite. Artificial flower arrangements will be permitted to remain until they become faded or unsightly. Fresh flowers will remain until unsightly. No glass or ceramic flower containers or ornaments shall be allowed, however, a plastic flower container no more than six inched deep, six inches wide and 24 inches long may remain in place unless broken or in decrepit condition. No wires shall be allowed to hold flower arrangements permanently in place at the interment site. Blankets are allowed to be placed prior to any holiday but must be removed within ten days following the holiday. L L; Initial Sod placement. Sod will be placed after the ground has settled following the burial to ensure a level surface and proper establishment of the grass. This process helps maintain the overall appearance and integrity of the cemetery grounds. L. Initial Permanent Markers. All markers shall be installed within 120 days after burial. Where this regulation renders a hardship or presents any special problems, such as an estate not settled, special consideration will be given. Request for special consideration should be make in writing to the Sebastian Parks and Recreation Director, 1225 Main Street, Sebastian, Florida 32958. J_ • U Initial Unlawful Conduct. Our Ordinance states that it shall be unlawful for any person to possess or consume any type of alcoholic beverage within the cemetery grounds. L ' C.- Initial Violations of article; penalties. A violation of any of the rules and regulations contained in this article shall be considered a violation of the ordinances of the city, and any person adjudicated in violation of such rules and regulations shall, in addition to any penalty imposed by court not exceeding $500.00 fine and/or not exceeding 90 days imprisonment, be denied the right to do further business in the cemetery of the city. Initial I acknowledge that I have read and understand the contents on this form. \o c 0,:C7 !! If Signature Date CITY OF SEBASTIAN 17028 FINANCE DEPARTMENT RECEIPT Name Lint 64,rtcz. ICash Date t 3 1 Z U 2S ❑ Check # ❑ 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 601010 343800 Cemetery Lot Sales 2 g 5 �• 0 O 001501 343805 Cemetery Fees 480010 341920 Bldg Dept Copies _ PD Shop with a Cop PD COPE PD Cadets PD SRT Initus— — Total Paid Zfl�SD.CD Whyte - Dept. of Ortgln . Yellow - Fi nance Dpt. • Pink -Applicant