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Home My WebLink About4-28-30Name e Jff V, Aof- S / 6,4 `% A Unit Block Lot 30 Date of Mark -out rl;2 5 z 7 r Date of Burial O Time ! 00 ��YD AF,) Name of Funeral Home A6,645 -/(f 1 D If Authorized by NA Air Certificate No. 2539 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: James W. Cain 2000 SW 5th Drive Okeechobee, FL 34974 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 lots: Unit 4, Block 28, Lots 29 & 30 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 18th day of May, 2017. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin City Manager ATTEST: J anette Williams; City Clerk ! I' Ruby Sibayan 1946-2017 Ruby "Marlene" Sibayan, 70, of Indian Harbour Beach, passed away on May 17, 2017. She was born on July 30, 1946 in Vero Beach, FL to the late Neil and Ella Cain. Marlene was a faithful member of the Church of Christ in Cocoa. Marlene retired from Acopian Technical as a manufacturing supervisor after 30 years of service. She enjoyed reading, crosswords, and in her active years, bowling. Most of all she cherished her grandchildren. Marlene is survived by her beloved husband of 46 years; Cecilio Sibayan, children; Wendy Littleton, Trina Massie (Dustin), and Celio Sibayan (Jessica), grandchildren; Rebecca Littleton, Rachel and Dylan Massie, and Mick, Cecelio, and Kima Sibayan, and brother; J.W. Cain. She was predeceased by her brother Neil "Butch" Cain. I 1225 Main Street Sebastian, FL 32958 (772) 589-5330 Phone May 31, 2017 Mr. James Cain 2000 SW 5t' Drive Okeechobee,FL 34974 RE: Interment Rights to Unit 4, Block 28, Lots 29 & 30, Sebastian Municipal Cemetery. Dear Mr. Cain Enclosed is City of Sebastian Certificate 2539 entitling you to full interment rights in Unit 4, Block 28, Lots 29 & 30 the name of James W. Cain. If you have any questions, please contact our office at 388-8209. Sincerely, Cathy Tes Records Clerk Enclosure 3vlcc o �Cca 0.t c- !tet S as c( Caw �GCc �0,q, 5/25/!7 4-(': W CMOf 5 . T A63 9 HOME OF 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 or person for whom lot is intended for interment must be provided at time of purchase. IT es to, Name(s) Address R,3--7(, 3- R/24 M- S bei;461r-) of Intended Occ ant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: f �, Fut I r� AN L4 ` Dollars ($ � , 00 ) on this ('2 day of , 2017 for the purchase of the following described Cemetery Lot(s) and/or Niche(s). 2-1 30 ZS{ Unit Block �, 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: Corner Markers (set of 4 - $20) Opening & Closing �t l �, �7 / W O H Circe One Vase and Ring for Niches (cost) Interment Disinterment Temporary Marker Preparation & Installation Signature of Purchaser I:\W W-DATA\Ms-Cemetery\RECEIPT.doc TOTAL $ l 5D • �� City of Sebasti The following documents were provided as Proof of Residency: and ! CITY OF 2 ` ' �'� `''' Seacoast CHECK No.. 0 913 5 7 SS'�L��a�,".a=:a:: CfTYOFSEBASTIAAI 1225 MAIN STREET NATIONAL BANK 91357 SEBASTIAN, FL 32953 J' GENERAL ACCOUNT HOME OF PELICAN ISLAND ********950 DOLLARS AND 140 CENTS PAY Marisa Insolera 21 Prince -Charming Ro TOTHE Nesconset ORDER VENDOR CHECK DATE CHECK AMOUNT 621 12/04/201 $950.Oq VOID IT NOT 9A WITHIN 90 DAYS NY 11767 ►r nr TWO SIGNATURES REQUIRED II.0913570 1:06 700 5 1. 581: 4 3 2 7 10 388 11I• 91357 :ITY OF SEBASTIAN SEBASTIAN, FL 32958 120415 INVOICE DATE INVOICE NUMBER INVOICE DESCRIPTION NET INVOICE AMOUNT PO NO. 11/25/15 Buy Back Buy Back Of Cemetery Lot 950.00 091357 110723 626 Marisa Insolera 950.00 91357 CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash Due Date To Be Completed By Department 12/4/2015 Single Check Y / N y Vendor Number LN TC Organization Reference Code Object Project Code Code Amount 601010 343800 $950.00 Description Number of Lines Amount $950.00 Marisa Insolera wishes to sell her cemetery lots back Copy of original deed and and buy back deed attached S 1000.00 minus 5%u administration fee ISSUE CHECK TO NAME Marisa Insolera ADDRESS 21 Prince Charming Road CITY Nesconset STATE NY ZIP CODE 11767 DRAW CHECK FROM SCE BELOW APPROVED BY DATE t Z BUDGET APP C� MA11 ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach a copy of doctmtenmtion along with the original) OTHER INSTRUCTIONS Please give copy of check to Jeanette State of Florida, Department of Health, Bureau of Vital Statistics o BURIAL TRANSIT PERMIT HEALTH DATE PRINTED: May 30, 2017 TRACKING NUMBER: 2017081733 1. DECEDENT INFORMATION Name of Deceased Date of Death RUBY MARLENE SIBAYAN May 17, 2017 Place of Death - County City, Town or Location Name of facility, or street address if not a facility BREVARD MELBOURNE HOLMES REGIONAL MEDICAL CENTER Name and Address of Funeral HomelDirect Disposal Establishment Fla. Lic. NO.IReg, No. Phone Number BEACH FUNERAL HOMES 8 CREMATION SERVICES - EAST F052125 F052125 (321) 777-4640 1689 S PATRICK DRIVE INDIAN HARBOUR BEACH, FLORIDA, 32937 Funeral Director/Direct Disposer Fla. Lic. No.IReg. No. CHRISTOPHER D. VIEIRA F048223 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: 8052125-5099 May 1 �— Date Issued: May 18, 2017 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: J 0 h 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 CITY OF SEBASTIAN 10448 ADMINISTRATIVE SERVICES RECEIPT Name 1-RIN ❑Cash Date—I g I YCheck # ❑ 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 �( Cpt'gol - 3+3g05 01C I (evi 010 sq- ' �_,� Qoa Lm *amu co .L/,3,W Total Paid i 5d"o Initials Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant MYOF SES, HOME OF PELICAN ISLAND CITY OF SEBASTIAN Cemetery Certificate THIS INDENTURE MADE this 24th day of November, 2015, between Marisa Insolera, as Grantor whose address is 448 Seagrass Avenue, Sebastian, FL 32958 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 $1,000.00 to be mailed minus a 5% 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 lots 29 & 30, block 28, unit 4, 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. Witne s ..' By. Marisa Insolera, Grantor STATE OF rt o r 4'j -q - COUNTY OF frinitai-\ f�i ler I HEREBY CERTIFY, that on this 7'/"' day of e'u w i' 2015, before me personally appeared Marisa Insolera who produced Fz- I) -r ver; L, c,� i'"iS( as identification; and who executed the foregoing conveyance to the City of Sebastian and severally acknowledged the execution thereof to be her free act and deed as such an individual duly authorized. 1- �',V. r�s'sioy $ ,•Vo II)ary 28, 2pdo •. 4 (Notary Public MFF 186485 : _o` ��%94'u......p,��`\`�J Tity of #rbaottan Trmrtrrjj Derb NO. `,1664 3rd December 98 THIS INDENTURE MADE Tb a day of ............................................. A. D., 19......, between the City of Sebastian, a municipal corporation existing under the taws of the State of Florida, as Grantor and ....... I ........................... Roaario . and/or. Marisa .Ins..olera....................................................... 448 Seagrass Avenue ................................... Sebastiani ..1..32,358 .......................... ....... ............... ...................... of the County of .Indian ,River .......................... ani State of ...... FUrida...................................... as Grantee, WITNESSETH: 1 000 00 , to it in hand p That the Grantor for and in consideration of the sum of $ ,; .....•.................. � paid, the receipt whereof is herewith ac- knowledged, o-knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee Ltlelr. , heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: Ali of Lot(s)29&30. Bio&B........ UNIT , .4.......... , of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; said land now lying and being in Indian River County, Florida. To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the fust part has caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year fust above written. �J�1 - ............ Attest: City Clerk Signed, and Delivered In the r c oft It .. / .— ............. STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA 195— By.... ................. ..... Mayor ((aitt pSeal) I HEREBY CERTIFY, That on this 3rd..................day of ........... DEce tier............................. 1188.., before me personally appeared .. Ruth ..SUlllv.an Kathryn.M. ..O'Halloran ....................................... and ................ ......... respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the laws of the State of Florida to me known to be the individuals and officers described in and who executed the foregoing conveyance to „, , , , Rosario . and/or, Marisa, ,Insolera , ,, , . ............................................................................ ........................................................ and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorized; and that the Official seal of said corporation ly affixed thereto, and the said conveyance is the net and deed of said corporation. WITNESS my signature and official seal at Sebastian, in the Ctn�r I len Iver on State of Florida, the day and year lest aforesaid. n� u.IIg .tut ;vrUaattatt �rmr#rrg D r r b NO. "1664 THIS INDENTURE MADE This ...... 3Ld........... day of..December......................................... A. D., 1998..., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida. as Grantor and ................................... ROSaaa . andlar. Marisa.InsDlera....................................................... 448 Seagrass Avenue ................................... Sebastian, .. FL. .32958 .......................... ............................................ of the County of . IIlflj;anXVPS.......................... aol State of ...... F..IDL'7,dA............... ................ ....... u Grantee, WITNESSETH, th That the Grantor for and in consideration of the sum of $ 110007 000 00 ........... , , , , , to It in hand paid, the receipt whereof Is herewith ao ....... knowledged, does by this instrument giant, bargain, sell, release, convey and confirm unto the Grantee th .eir..,. heks, legal representatives and assigns the following property situated In Sebastian, Indian River County, Florida, to -wit: Ail of Lot(s)29&30. , Blo.lf ........ UNIT ..4.......... , of Sebastian municipal cemetery as per Plat Number I thereof recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St. Lucie County of Florida; mid land now lying and being N Indian River County, Florida. To Have and to Hold the same forever; provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto- fote, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions, restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the faBma of the owner of any property situated within said cemetery to ob- serve and comply with such rules, regulations, resolutions and ordinances and the conditions of the tided of conveyance thereof then the title of such owner in and to said property shalt terminate'and the same shall revert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The sold party of the fust part has mused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed, the day and year fust above written. Attest, /•d (•V•i `. G1 . ............ City Clerk Signed, urnd Delivered In ?rc#&12............. l. L t`.r....................... STATE OF FLORIDA CITY OF SEBASTIAN, FLORIDA By..................... Mayor ((gill; 'Senl) COUNTY OF INDIAN RIVER Decr embe............................. I HEREBY CERTIFY, That an this .,3rd,,,,,,,,,,,,,,,,,,..y nr ............. Ruth Sullivan Kathryn M. O'Halloran before me personally appeared Clerk f the . City o .Sebas Sebastian, a . municipal ......... ........ and ................... 1................... -*- respectively Mayne and CIfY Clerk of the City of 9ebasHan, a municq,ol corporntlon under the laws of the Stale of Florida m me known to be Ilm Individuals nod officer. described In and wbo executed the foregoing conveyance to ....................................... Rosario •and/ or. Marisa, ,Insolera................................................... •,,, ... and severally acknowledged the execution thereof to be their free let and deed as such officers thertu,to duly authorised; and that the Official sent of said corporation �1�e-� ly\ affixed thereto, and the said conveyance is the std and deed of said corporation. WITNESS my signature and official aeal at Sebastian, In the lest aforesaid. MYCOMMISSION My State of Florida, the day and year