HomeMy WebLinkAbout4-45-03Paid by CEMETERY Receip
List :.0..°. .....
Net Paid $ ... ~.5~ ,.O0. .....
Mar±e Farre11 interred
Lot. 4, Blk.45, Un.4
Maximum No. Burial Spaces .................
Lots 3 & 4
Blk.45,Un.4
Monument permitted ....................... Thomas Farrell
P.O.Box 952
(Data above mis line for City Record only) Roseland, F1.
NO.
i149
32957
(llitl! of ebastian
emelery Deei
NO.
. Z49
THIS INDENTURE MADE ~ .... 15th .......... day of ........... No.v.emhe.r .................... A. D. 1g..8.9.,
between Ibe City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
..................... .T.h.p.m..a.~...F..a.~..r~.! !.. (.R~.s. id.ing..s.C..Lo.t.. 3 ,...Palme.r~. C.o.u~ ~ ..........................
P.O.Box 952 11330 U.S. 1, Sebastian, Fi.)
........................ Ro~ e land.,..F.1 ...... 32957 .........................................................................
of tb~ con,fy of ......l.p.~.n..~.v.~.V .................hi Stale of .F.l~Ki.d~ .........................................
· s Grantee, WITNESSETH~
That the Grantor fo, and in consideration of the sum of $ ..~.O. ?.0. :.0..0. .............. to it in hand paid, the ,eceipt whereof is herewith ac~
knowiedgad, does by this instrument grant, bargain, sell, mlea se, convey and confirm unto the Giantee . .h..i.s.... heirs, legal mpresantatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to-wit;
All of Lot(s) .3...~...~, Block, .~.~. ...... UNIT .. ~ .......... of Sebastian raunic/pal ceraete~y as per Plat Number 1 lhereof recorded in Plat
Book 2, at pete 65 of the public records in the office of the Clerk of the Ckcuit 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 u~xl, kept and maintained at all times in accordance with the rules and ieguhtions, ordinances and resolutions of the City of Sebastian, Florida, hereto-
fore, now and hereafter adopted o! provided for the government and operation of said cemetery. The conditions, restrictions and mqukements contained
in this instrument shall be covenants running with the land. tn the event of the failure of the owner of any property situated within said cemetery to ob-
seiwe and comply with iuch rules, regulations, resolutions and oldinances 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 first pa~t has c~used 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 first above written.
Attest:
City Clerk
CITY OF SEBASTIAN, FLORIDA
,, ..............
Mayor
Signed, Sealed and Delivered
In the Price of: ///
STAT~, OF FLORIDA
COUNTY OF INDIAN RIVER
5
th
November
to be the individuals and officers deserted In and who executed thc ton'going conveyance to
........................................................ and severally acknowledged the execution thereof to he their free act and deed
as such officers ti~ereunto duly authorized; and that the Official seal of said corporation Is duly affixed thereto, and the 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.
Notary Publ[ff, State of Florida at Larse.
My commission expires: Holnry Publk, State of florida
My (ommlsfi:m E::~ir~s ~c. 10, 1992.
FARRELL, THOMAS DEED #1249
Lot 3,. Palmer Court
11330 U.S. 1
Sebastian, Fi.
Mailing Add.: P.O,Box 952
Roseland, Fl. 32957
Lots 3
Blk. 45
Un. 4
Marie Farrell interred Lot 4 11/16/89
11- 7 7- 1
L ..... 325.00
NetP~dS ...fiSD.OQ .....
Marie Farrell interred
Lot. 4, Blk.45, Un.4
Lots 3 & 4
NO,
2 Blk.45,Un.4
Maximum No. Buzial Spaces .................
Monument ~erm~tted ................. ~ ~ 4 ~
...... Thomas FarreI1
P.O.Box 952
(Data above t~l. line for C~ty Record only) Roseland, F1. 32957
CITY OF SEBASTIAN
crrY CLERK'S OFFICE
RECEIPT
001501 369400
001501 369400
680~0 220681
680800 22(}682
Sales Tax
Garage Sales
Copies/Bid Specs
LDC/~ode of Ordinances
Communiiy Cenler Renl
Yachl Club Renl
Non Taxable Renl
Cernele~y Lots
Cemelery Lois
Lot/Niche Block
Inlerment Fee
Weekend Service
Yacht C~b Securily Oepesil
Community Center Securily Oepo~it
Riverview Park ~ecu~ty Dep~Jl
0211
O &lsh
A~ount Pak
Unil
Total Paid
White- DeC. of Origin · Yellow- Fbmne* · Pink- Appliunt
City of Sebastian
POST OFFICE BOX 780127 a SEBASTIAN, FLORIDA 32978
TELEPHONE (407) 589-5330
FAX 407-589-5570
December 14, 1989
Mr. Thomas J. Farrell
431 South Papaya Circle
Barefoot Bay, Florida 32976
Dear Mr. Farrell:
Thank you for your prompt return of Receipt No. 597 with
your signature. I am returning the other copy to you for
your records.
I am also returning to you the form - Return for Transfers
of Interest in Florida Real Property - which must be recorded
along with Deed No. 1249, previously sent to you, in the
office of the Clerk of the Circuit Court, 2145 14th Avenue,
Vero Beach, Florida.
ve~truly yours,
/? -,..-./ ,"2 "/
E-~(abe(h Reid
Administrative Secretary
LR
Enc.
City of Sebastian
POST OFFICE BOX 780127 ~ SEBASTIAN. FLORIDA 32978
TELEPHONE (407) 589-5330
FAX 407-589-5570
December 11, 1989
Mr. Thomas Farrell
P. O. Box 952
Roseland, Florida
32957
Dear Mr. Farrell:
Enclosed is Cemetery Deed No. 1249 for Lot(s) No. 3 and 4,
Block 45, Unit 4. If you wish to have this deed recorded,
may do so at the office of the Clerk of the Circuit Court,
14th Avenue, Vero Beach, Florida.
you
2145
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.
We are enclosing two copies of Receipt No. 597 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,
Elizabeth Reid
Administrative Secretary
LR
Enc.
THE SEBASTZAN CB~TERY
Ctt~ of Sebastian
Sebastian, Florida
RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF:
FROM:
R~× hundred fiftv and 00/100
Thomas Farrell (Residing at Lot 3,
S=b~ti~,i, Fl.)
P.O.Box 952
Dollars ($650.00 )
Palmer Court, 11330 U.S.
Roseland, Fi. 32957
on this 15th da~ of November , 19 89for the purchase of the following
described Cemeterg Lot(s) upon the terms and conditions as stated herein:
Description of Fropert~:
' Cemeter~ Lot(s)# 3 & 4 Block# 45 Unit# 4
Purchase Frice~ Three hundred twenty-fiveDollars($
Terms and'conditions of sale:
325.ea.)
This contract shall he binding upon both parties, the seller and the purchaser, when
approved b~ the owner of the propert~ above described.
I, or we, agree to purchase the above described propert~ on the terms and conditions
stated in the foregoing instrument:
The Cit~ of Sebastian agrees to sell the above mentioned propert~ to the above named'
purchaser(s) on the terms and conditions stated in the above instrument.
'Cltg of S~basttan
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
A. (TYPE)
1.DeceasedName of First Middle Last Do°~thDate Month Day
Thomas J. Farrell Nov. 13
Year
2001
2. Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp. or
Indian River Roseland nst. Sebastian River Medical Center
3. Name of Medical Address Phone Number
Certifier Muhammad Siddi~.~., M.D. 937 Barefoot Blvd.
i--']Medical Examiner I'~ IPhysician Barefoot Bay, FL 561-664-4349
4. Name of Funeral Home/Direct Disposal
Establishment
Strunk Funeral Home
5. Check a. []
Appropriate
Address1623 N. Central Ave, Fla. Lic. No./Reg. No. Phone No. (Area Code)
Sebastan, FL 1228 561-589-1000
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
?
medical.e~i~catio~, of ceuse~.ef de.within 77 hours.
6. Funeral Director/ ~~ Si at .~ ~_~.~ ?~..~.~ F.E. No./Re~..
Direct Disposer ,~ , .~ ~ ,~ 1862
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body.
Martha was contacted on 11 / 13/01
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. Siddiqui 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
Date Signed
11/13/01
Permit No. 1228-01-0546
[] 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 cer[ificate within
72 hours.
[] No extension of time for filing the death certificate has been requested.
1~ ~ ~ Date Date Celtificate
S u bregistrar Signature /~ Issued: J*//~3/O~ Due: ,/ /[~/OJ
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number: Date
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
E-]CREMATION
Signature of Sexton
or Person-in-Charge
[~STORAGE
F-"~OTHER (Spec~)
CEMETERY OR CREMATORY
Place of Disposition Sebastian Cemetery
Date of Disposition
This permit must be endorsed by the Sexton or person-in-charge or by the Funeral Director/Direct Disposer when there is no Sexton) and returned
within 10 days to the local County Health Department in the county where dispos tion occurred.
(Stock Number: 5740-000-O326.2) Pink Local Regis(fa'