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HomeMy WebLinkAbout4-45-40Name lie Unit Block Lot { y Date of Mark -out � / � Date of Burial Time Name of Funeral Home11 S Authorized by T Cl, \'MM J sua, ut lip 0 w d r � � L 0 8 0 d W r !Ew 8 �p 1pn Itpf 1pn G 1t� _ ; S d 6 w � o ~ e d e s g 0 State of Florida, Department of Health, Bureau of Vital Statistics -_ Oil _ d BURIAL TRANSIT PERMIT F1oHEALTH DATE PRINTED: May 10, 2017 TRACKING NUMBER: 2017077380 DECEDENT INFORMATION Date of Death Name of Deceased FILOMENA M MANDARA May 9, 2017 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH INDIAN RIVER MEDICAL CENTER Name and Address of Funeral HomelDirect Disposal Establishment Fla. Lic. NO.IReg. 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.IReg. No. F022789 TIMOTHY W. MARVIN 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: 2017-F041670-5013 Date Issued: May 10, 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 fI I i/v'�I Method of Disposition: BURIAL Date of post ti6n: 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, 10/12 64V-1.011, Florida Administrative Code J /y CEMETERY Receipt No. .... :'. 44........ Dated .... 1I16 /88.............. Lots 39 & 40 NO. J 350.00 B1k.45, Un.4 List Price $ .................. Maximum No. Burial Spaces . �.......... . Net Paid$ .......7.OQ.AO.. Monument permitted..........:. EDWARD & ROCHELLE 1199 NORMAN 7860 94th Ct., (Data above this line for City Record only) Vero Beach, Fl . 32967 hiit� of �phtt�zitttt %�kPItrmtrrg Brpb No. 1199 THIS INDENTURE MADE TWa ....... 16.th........ day of ....... NDVe .IRber ........................ A. D., 19...8.8. between the City of Sebastian. a municipal corporation existing under the laws of the State of Florida, ac Grantor and ......................... Edward,.and_Rochelle Norman ......................................................... ............................... 7860 94th Court, Vero Beach, Florida 32967 ...................................................................................................... ............................... of the county or Indian River Florida .............. ............................... aml State of ........................ ............................... as Grantee, WITNESSETHr That the Grantor for and in consideration of the sum of $ OO . OO to it in hand paid, the receipt whereof is herewith ao• knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee . their heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: 40 AB of Lot(s) .... & , Block, 4 5 , 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; said land now lying and being in Indian River County, Florida. Rochelle Norman to be interred in Lot No. 40. 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 iuch 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 first 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 First above written. Attest c City Clerk Signed, Sealed and Delivered In the Presence of: STATE OF CITY OF SEBASTIAN, FLORIDA Mayor Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 2 ROSARIO "GEORGE" MANDARA IView /Sign Guestbook ROSARIO "GEORGE" MANDARA Rosario "George" Mandara, died , June 7, 2008, he was born February 11, 1918 to Concetta and George Mandara of Hackensack, NJ. Prior to World War II, George was with the N.J. National Guard. During World War II George served six years with the U.S. Army's 177 Engineer's division, stationed in Alaska. Upon returning to the states, he met and married the love of his life, Phyllis Allu. They would have celebrated their 62nd Wedding Anniversary , July 13th. George and his wife have four children. Prior to moving to Vero Beach in 1970, George owned and operated "George's Auto Body Works ". A Jack of all traits and master of all. His creative mind and hands were always working. He is preceded in death by his Grandson, Christopher R. Norman; his Brother, Anthony Mandara; Sisters, Josephine Angona, Stephana Dicosmo. Survivors include his wife, Filomena; Son, George A. Mandara and Wife, Natalia of Vero Beach; Daughters and Sons- in -law, Rochelle and Edward Norman, Marlene and Albert Sansone of Vero Beach, Deborah and Benjamin Kendrick of Melbourne Beach; Grandchildren, Mark Nalewaiski, George A. Mandara, Jr, Danielle Hampton, Michael Sansone, Amanda Kendrick, Jon Kevin Norman, Hunter Kendrick; Great- Granddaughter, Skyler Hampton; Sister, Carmella Brancato; and several nephews and nieces of N.J. The family will receive friends from 1 -2 p.m. June 10, 2008, at the Strunk Funeral Home, Sebastian, FL. A funeral service will follow at 2 p.m., in the funeral home chapel. Interment will follow in Sebastian Cemetery with full Military Honors conducted by the Sebastian Area Veterans' "Honor Guard. The family has requested that memorials may be made to VNA & Hospice Foundation, 1110 35th Lane, Vero Beach, FL 32960. He will always be remembered for his love of family. His beloved dog Rex and passion for his doves. "Phil, I love you more today than yesterday and for eternity ". Published in the TC Palm on 6/10/2008. Notice • Guest Book • Flowers • Gift Shop • Charities http: / /www. legacy. com /tcpalm/Obituaries.asp?Page =Life StoryPrint &PersonID= 11126... 6/10/2008 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY r HOME OF PELICAN ISLAND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home ADDRESS: 1623 North Central AYenue, Sebastian, FL 32958 PHONE #: 772 -589 -1000 (Chec,lc One) if OPEN BURIAL LOT Lot d1O Block Unit OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: June 10, 2008 2 P.M.— FOR DECEASED: Rosario George Mandara Name 0- 4- 13 - �5 NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of owners: o A c..1 % L /%?• c> rrn ate, Name Signature Date 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 IGNATURE OF LICENSED FUNERA T . Name Signa re 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 thayall es have been paid: /t I AR 16 Cemet Sex n Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. FLORIDA DEPARTMENT OF HEALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of Rosario George Mandara .tune 7 2008 2. Place of Death City, Town or Location Name of __]Death (if neither, give street address) County Hosp. or Indian River Inst. 1076 41 st Avenue 3. Name of Medical Address Phone Number Certifier Michael Venazio, M.D. 8005 83rd Avenue Medical Examiner Physician Sebastian, FL 772- 388 -2110 4. Name of Funeral HomeQ0e&5isp m&- Address 1623 N. Central Ave. Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 1trunk Funeral Home 6 Cremat y Sebastian, FL 1228 772 - 589 -1000 5. Check Appropriate Box a. U The medical certification has been completed and signed. A completed certificate of death accompanies this application. b. A Liz was contacted on 6/9/08 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Venazio will complete and sign the medical certification of cause of death within 72 hours. C. ❑ was contacted on death within 72 hours. He /she verified that Medical Examiner, will complete and sign the 6. Funeral Director/ Sin ure F.E. No./Reg. No. Date Signed Bireel-Bifss6l;'�r g �/J 44048 6/8/08 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -08 -286 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. Regietferor-• Date Date Certificate Subregistrar Signature Issued: 6/7/08 Due: 6/12/08 C. 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. D. CEMETERY OR CREMATORY Method of Disposition: Place of Disposition Sebastian Cemetery BURIAL STORAGE Date of Disposition G � /(% CREMATION OTHER (Specify) Signature of Sexton 1 or Person -in- Charge 1) 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 disposition occurred. DH 326, M7 (Obsoletes all previous editions) (Stock Number: 5740- 000 -0326 -2) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar sew J& P-r-