HomeMy WebLinkAbout4-48-09Name
Unit
Block
Lot
Date of Mark -out
Date of Burial %Time
Name of Funeral Home a X uk/ /L-- . - -
Authorized by
/V,
...:..r=ter""..
-I. Condolences w- reg
istered at Seawin&fh.com/ I
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SEBASTIAN
Leroy Clinton Pease
LeRoy Clinton Pease, 85,
died March 24, 2006 at his
home.
He was born in Pennfield,
Pa., and moved to Sebastian 25
years ago, coming from Indi-
ana, Pa.
He was a coal miner with
the R & P Coal Company in Er-
nest, Pa., for 24
years.
He was a mem-
ber of the Eagles
Sebastian Inlet
Aerie #4067 and
the United Mine
Workers of America
Survivors include his wife of
66 years, Lorraine Pease of Se-
bastian; son, Clinton Pease of
Sebastian; sister,.Hazel Bothel
of Worthington, Pa.; two
grandchildren; one
great-grandson.
He was preceded in death by
a granddaughter, Connie
Pease.
SERVICES Visitation will be
from 6 to 8 p.m. March 31 at
the Strunk Funeral Home, Se-
bastian. A service will be ii
ELM April 1 at the Strunk Fu-
neral Home Chapel, Sebastian
with the Rev. James C. Kepler
officiating. Interment will be
in Sebastian Cemetery, Sebas-
tian.
BEACH
fo
a
A.
FLORIDA DEPARTMENT OF
HEALT
Name of First
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
Deceased
of
LeRoy Clinton
Pease
I Death
March W02006
2. Place of Death City, Town or Location
Name of (If neither, give street address)
County
Hosp.or
Indian River Sebastian
Inst. 7617
133rd Square
3. Name of Medical
jAddress
Phone Number
Certifier Edward J. Miller,M.D.
13855 U.S. #1
Medical Examiner Physician
Sebastian, FL
772-589-8992
4. Name of Funeral Home/DheeHNsposat–
Address
Fla. Lic. No./Reg. No.
Phone No. (Area Code)
Establishment
1623 N. Central Ave.
1
Strunk Funeral Home
Sebastian,
FL
1228
772-589-1000
5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. d Patti was contacted on 3/27/06
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Miller will complete and sign the medical
certification of cause of death within 72 hours.
C. was contacted on He/she verified that
Medical Examiner, will complete and sign the
1 rti on of cause of death within 72 hours.
6. Funeral Director/ Si F.E. No./Reg. No. Date Signed
Dvei;t— eser 1862 3/24/06
B. BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-06-0133
F] A five (5) day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has
been contacted by the funeral director and will not be able to complete the medical certification of cause -of -death section of the death certificate within
72 hours.
�No extension of time for filing the death certificate has been requested.
Registrar M Date Date Certificate
Signature v
Issued: 3/24/06 pqe. 3/29/06SubregistrarQ
C.
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA
Approval Number Date
In
Medical Examiner, , gave authorization by telephone to
Funeral Director/Direct Disposer. Date
The Medical Examiner's approval must be obtained before disposal by any of the above methods. A waiting period of 48 hours after death is
required for all cremations.
Method of Disposition:
BURIAL
CREMATION
Signature of Sexton
or Person -in -Charge
STORAGE
OTHER (Specify)
This permit must be endorsed by the Sexton or
within 10 days to the local County Health Depal
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
Date of Disposition
in the county where disposition occurred.
Disposer when there is no
and returned
DH 326, 897 Obsaleles all ) Disbibulbn: white: Cemetery w Crematory
( previous a fti Yellow. Funeral Dtre w Direct ois,xmr
(Block Nmbm 5740-0DDU326-2) PN L Registrar , `�
hid y CEM£XEEY Re~i~ No...6..6.0
Maximum No. Burial Spaces ................ .
Monument permir tad .......................
(Data above t~in line for City Record only)
O itff nf ha tiau
( eme ery eeh
ts 9, 10
ock 48
it 4
NO.
Clinton Pease
367 Bayharbor Terr.
Sebastian, Fl. 32958
NO.
THIS INDENTURE MADE TI~ 13th aay of FebruarM
.................................................................. A, D~ l~..?,~..,
between the City of Sebastian, a municipal enrpor&tlon existing under the laws of the State of Florida, ns (]rant. or ami
.... Clinton Pease
......... 3'6'T'~'A'gH~f'~ ~ ~ ' 'i'6 ~ ~ 2 ....................................................
................................................. Sebas. tian,.. Elo. rid a..329 ~ 8.
of the County of ...In..d~.a..~...R~..y.e.[ ..................... an.I state of ......... %!.orida
as Grantee, WITNL~SSETH! ..........................................
That the Grantor for and in consideration of the sum of $ .~..0.0..,.Q.O. ...... to it in hand paid, the receipt whereof is hetewirh ac
t~;~ol~gweind,gd~s~ t~j~estjUinm~nethag~nt, ba.ai~, sell, tel.., convey and confl~ un~;'t;; '~,'a~teo..~..i~... heirs, legal repre.ntative, and assign;
P P Y ' ~n, ln~n River County, Florida, to-wit:
~ of Lores) . ~., .~ Q, Block,. b. 0 ..... UNIT ...~. .......... of Sebastian munidpal cemetery as l~t rht Number 1 thereof recordnd in Plat
Book 2, at pre 65 of the public records in the office of the Clerk of the Ckcuit Court of St. Lucie County of Florida; ~aid land now lying and bei~
in indian River County, Flosids.
To Have and to HoM the same forever; provided that said property shah 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 ruler and regulations, ordinances and resolutions of the City of Sebastian, Florida, hereto-
fore, now and hereafte! adopted or provided for t,he government and operation of said cemetery. The conditions, restrictions and requirements contained
in this instrument shah 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 ~uch rules, regulations, resolutions ami.ordinanoes end the conditions of the deed of conveyance thereof then the title of such owner
in and to said property shall terminate and the same shah revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said party of the first part has caused this instrument to be executed in its name and on its behaff by its Mayor and
attested by its City Clerk and its corporate seal to be hereto affixed, the day and year lust above written.
~ City C~erk
Signed, Sealed and Delivered
In th~Presen.ce of: /3 ~
COUNTY OF INDIAN RIVER
CITY OF SEBASTIAN, FLORIDA
I HRIIEBY CERTIFY, Thai an thin ........ 13. th ......... day of ......~ehr.uaE¥. .............................. , is. 9 ],
~4~'fo're me personaly appeared · E. Conyers . Knt'hrxz. 0 'w~13 ....
respcchvely 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 comveyance to
........................................................ and severally ~nowl~ged the execution ther~f to ~ ~elr free act and deed
as anch officers thereunto duly author~ed; and tbat the Official ~al of said corporation la duly affixed the~ and the said conveyance
is the act and deed of ~ld ~rporuOon.
WITNESS my slgnn~m and offlcl~ ~ at Sebastian, in the ~unty of Indian River and State of Florld~ the day and year
last afor~d.
.............
~ubHc, State of Florida at ~r~e.~
~ Commbs~n E~r~ t:~3'~130, 1994
LOTS 9, 10
BLOCK 48
UNIT 4
DEED #1314
· CLINTON PEASE
367 BAYHARBOR TERR.
SEBASTIAN, FLORIDA 32958
(D~ta above fl~ls line for City l~e~ord
Lots 9, 10
Block 48
Unit 4
NO.
Clinton Pease
367 Bayharbo~.Terr.
Sebastian, Fl'. 32958
City of Sebastian
POST OFFICE BOX 780127 [] SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330 [] FAX (407) 589-5570
February 22, 1991
Mr. Clinton Pease
367 Bayharbor Terrace
Sebastian, Florida 32958
Dear Mr. Pease:
Enclosed is Cemetery Deed No. 1314 for Cemetery Lots 9 and 10,
Block 48, Unit 4. If you wish to have this deed recorded
you may do so at the office of the Clerk of the Circuit Court,
2145 14th Avenue, Vero Beach, Florida.
Also enclosed is a form - Return for Transfers of Interest in
Florida Real Property which must be filled out by you and
completed by the office of the Clerk of the Circuit Court when
and if you have the deed recorded.
We are enclosing two copies of Receipt No. 660 and ask that you
sign and return to us the copy marked with an "X" and retain the
other copy for your records. A stamped, self-addressed envelope
is provided for your convenience.
Very truly yours, ,
Kathryn M. O'Halloran
City Clerk
KMO:Js
enclosure
THE SEBASTIAN CEMETERY
City of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
on this /j~ day of~ZWZZ~, l:9?/for the purchase of the following
described Cemetery Lot(s) upon~he terms and conditions as stated herein:
Description of Property:
· Cemetery Lot(s)# .~/, /~ Block# ~'~
Terms and'conditions of sale:
Unit#
This contract shall be binding upon both parties, the seller and the purchaser, when
approved by the owner of the property above described.
I, or we, agree to purchase the above described property on the terms and conditions
stated in the foregoing instrument:
The City of Sebastian agrees to sell the above mentioned property to the above named
purchaser(s) on the terms and conditions stated in the above instrument.
~bastian _~/
February 8,
City of Sebastian
POST OFFICE BOX 780127 u SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330
FAX 407-589-5570
1990
TO:
FROM:
Finance Department
Kathryn M. O'Halloran, City Clerk
Please issue a check in the amount of $400.00, payable to the
following, for the re-purchase of Cemetery Lots 9 and 10, Block
48, Unit 4:
Lucille Held
202 S.W. Columbia Avenue
Sebastian, Florida 32958
Attached is Original Deed No. 1113 and Receipt No. 467.
LR
Enc.
February 8, 1990
TO: The City of Sebastian, Florida
We herewith request that the City of Sebastian,
Florida, buy back from us the following Cemetery
Lots:
Lots 9 and 10
Block 48
Unit 4
Attached is Original Deed No. 1113 which shows
that these lots were purchased on April 8, 1987,
at a cost of $200.00 per lot, for a total of $400.00
Charles F. Held
Lucille Held
202 S.W. Columbia Avenue
Sebastian, Florida 32958
L. Gene H&n'ls
Mayor
City of Sebastian
POST OFFICE BOX 780127 [] SEBASTIAN, FLORIDA 32978-0127
TELEPHONE (305) 589-5330
Kathryn M. Benjamin
City Clerk
April 28, 1987
Mr. and Mrs. Charles Held
202 S.W. Columbia Avenue
Sebastian, Florida 32958
Dear Mr. and Mrs. Held:
Enclosed please find Cemetery Deed No. 1113 for the purchase
of Lots 9 and 10, Block 48, Unit 4, Sebastian Municipal
Cemetery. If you wish to have this deed recorded, you may
do so at the office of the Clerk of the Circuit Court,
2145 14th Avenue, Vero Beach.
We are also enclosing a form - Return for Transfers of
Interest in Florida Real Property - which must be filled
out by you and completed by the Clerk of the Circuit Court's
office.
Very truly yours,
Deputy City Clerk
LR
Enc.
'ON
'~V ~q~[oD'fi'~ ZO~
'ON
.................. S P.~d ~N
oo' oo~
................. saoMS lm~n~ 'oN tunmpm~
z '"'o'6'"b'd:f~ .... '~'~ ~
...... ~ ~'/ i~"/ ~ ..... POi'Il ......... ~ ~I"oN ld,~o.~l A ll~J;aPI~I;:) ,iq P!~I
Paid bi' CEMETERY Receipt
ListPtice$... $200.00
$400.00
Net Paid $ ..................
No. Bar,,, S ce, ....... Z. ......... ! ! 13
Monumentpennitted ....................... Charles F. & Lucille Held
202 S.W.Columbia Ave.
Sebastian, Fl.
(Data &here this Bne for Clt~ Record only)
· of ebaslian
(!;emelery Beei
NO.
Tins ZNDENTURE MADE ~a, ...J~k ........... day of .............. April ...................... A. m. is.8.7..,
between the City of ~b~tia~ a m~lcJp~ ~r~ti~ ~ht~ ~r t~ laws of the State of FlorM~ ua Gran~r
............................. ~h~!~ ~..~.,.. ~nd.. ~c.i~ 1 ~.. ~.~ ~ .........................................................
............................. .... .........................
af th, ~ty ~f ..... !~.~..g.~. .................. an,l st~to o~ .............. ~!.9~ .............................
~ Grant~ WITN~E~
~t ~ Gr~tol roi ~d ~ ~n~ia~n of ~e ~ of $ . ~ ~ .'.~ ............... to it ~ ~d ~, thc ~e~ipt wher~f h ~m~th a~
~ow~e/, does by t~ ~nt ~t, b~, ~ re~, mn~y ~ ~n~ ~to ~ Gr~t~ ~ .~ ~e~s, ~l ~epm~ntafiv~ ~d ~s
~ fo~ pwp~y ~t~ted ~ ~ba~ I~ai~n ~er ~ty. HotlY, t~it:
~ of ~t(s~.. ~. ~ q B~,.. ~ .... UN~ . .~ ........... of ~b~ m,n!~l ~c~W ns ~r Pht Number 1 ~e~f ~rded ~ Pht
Book 2, at p~e 65 of ~ pubUc re~r~ ~ ~e offl~ of ~ C~k of the ~t ~ of St. Lu~ Cowry of ~; ~ ~d now ly~g ~d bei~
h Indlnn ~v~ Cou~y,
To Have and to Hold the same fomvar; provided that said psoperty *h*l! be used solely and exclusively for the intefraent of the human dead and shaU
be used. kept and maintained at all times in accordance with the rules and regulations, ordinances and rcsolutinns of the City of Sebastian. Flarida. hereto-
fore. now and hereafter adopted or provided for the govm-nment and ogexation of said cemetery. The conditions, restrictions and ~qukcments contained
in t~ ~nstrument shaB be covenants running with the land. In tile event of the latium of thc owner of any prol~rty situated withha said cemetery to ob-
set~e and comply with juch rules, seguJations, resolutions and.o~Linances and the conditions of the dc~ of conveyaace thereof then the title of such owner
in and to sa/d property shall terminate and the same shall revert to the City of Sebastian, Florida.
IN WITNESS WHEREOF, The said patty of the first part has caused tiffs instniment 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 first above written.
Signed, Sealed and Delivered
fn the P/~icence
..... .....................
STATE OF FIXIR1DA
COUNTY OF INDIAN RIVER
CITY OF ~EBA//TIAN,
r~s!~ctively Mayor anti City Clerk of the City of ~ebastian, a municipal cerporation under the laws of the State of Florida to me known
to be the individuals and officers deserlb~l in and who executed thc foregoing cmaveyance to
Charles F. and Luciile Held
........................................................ and severally acknowledged the execution thereof to he their free act and d~al
as such officers thereunto duly authoriaed: and that the Official seal of said corporation la duly affixed thereto, and thc said conveyance
is thc act and deed of said corporation.
WITNESS my: signature and official seal at Sebastian, in the County of Indian River and State of Florida, the day and year
last aforesaid.
I~¥ CO~#[SSlO# [XP O£C 10,1988
llt~U [.fi[kAL 1/15, U~, ~
UNIT 4, BLK. 48, LOTS 9 & 10 DEED #1113
Held, Charles F. & Lucille
202 S.W.Columbia Ave.
Sebastian, Fi. 32958
8507
Paid by CE.M~TERY Receipt No., ,4.6, .7. .......... Dated ..... .4, ,/.8,/.8, ,7, ...............
u~t mi~ $. $200.00 ~.axl~m ~o. ~uriai Spac=~ ...... Z
$400.00
N~ P,id $ ..................
Lots 9 a 10, Blk. 48 Unit 4
NO.
Mon,m~tmmm~ ....................... Charles F. & Lucille Held
202 S.W.Columbia Ave~
Sebastian, Fi.
(D~ a~ve ~ ~ ~r ~ 1~:o~
Citg of Sebastian
$~stian, Florida
RECEIPT IS BEREB¥ ~CFdqOWLE~GED OP THE SUN OF;
This contract shall be binding upon beth parties, the seller and the purchaser,
when approved bg the owner of the propert~ above described.
I, or we, agree t° purohaso the above described propert~ on the terms and
oonditio~.s stated ia tbe foregoing intrumant:
The Ciey of Sebastian agrees to sell the abOve mentioned property to the
abOve named purchaser(s) on tbs terms and conditions stated in £he abOve
instrua~nt.
'City
Wi t;~uss
L. Gene Harrl~
Mayor
City of Sebastian
POST OFFICE BOX 780127 [] SEBASTIAN, FLORIDA 32978-0127
TELEPHONE (305) 589-5330
Kathryn M. Benjamin
City Clerk
April 28, 1987
Mr. and Mrs. Charles Held
202 S.W. Columbia Avenue
Sebastian, Florida 32958
Dear Mr. and Mrs. Held:
Enclosed please find Cemetery Deed No. 1113 for the purchase
of Lots 9 and 10, Block 48, Unit 4, Sebastian Municipal
Cemetery. If you wish to have this deed recorded, you may
do so at the office of the Clerk of the Circuit Court,
2145 14th Avenue, Vero Beach.
We are also enclosing a form - Return for Transfers of
Interest in Florida Real Property - which must be filled
out by you and completed by the Clerk of the Circuit Court's
office.
Very truly yours,
Deputy City Clerk
LR
Enc.