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Home My WebLink About4-41-13r Paid by CEMETERY Receipt No 63 List Price 800.00 Net Paid 800.00 Americo Zarcone interred Lot 14 Attest: Signed, Sealed and Delivered In th ,i'resence of: STATE OF FLORIDA COUNTY OF INDIAN RIVER Dated 7 19. 0 Maximum No. Burial Spaces Monument permitted 6/20/90 (Data above this line for City Record only) Qitg Df 'Pttttitialt (1rmr#vrj Bead THIS INDENTURE MADE This 19th day of July A. D., 19 90 between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Matilda Zarcone 8600 t7.S. Hwy 1 Le t '98 Sebastian, FL 32958 of the County of XIldi-.a l..R.i \er and State of .E1.0. as Grantee, WITNESSETHI That the Grantor for and in consideration of the sum of 800.00 to it in hand paid, the receipt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee he r heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s) 1 3&14, Block, 41 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 first 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 first above written. By City Clerk 19th July •Lots 13 14 Block 41 Unit 4 1287 Matilda Zarcone 8600 U.S. Hwy 1 -Lot98 Sebastian, FL 32958 CITY OF SEBASTIAN, FLORIDA NO. (City Seal) I HEREBY CERTIFY, That on this day of 19 before me personally appeared W. E. Conyers and Kathryn O'Halloran 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 Mrs. Matilda Zarcone and severally acknowledged the execution thereof to be their free act and deed as such officers thereunto duly authorised; and that the Official seal of said corporation Is duly affixed thereto, and the said conveyance is the 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. NO. 1287 No ary Public, State of Florida at lotrge, commission expires; Notary Pun: btate of florid° My Ccrr.TT)ssien Expires Juno 18, 1994 Bonded Thru Troy rain Insurance Inc. Name /1 F ,<i /r',�C t� t;i-'[ ;-fit if Unit Block f 1 Lot Date of Mark -out Date of Burial Name of Funeral Home Authorized by c c CD a 0 bd Time z J•c 1:R H RECEIPT 4598 ame COX r -c-zv rd Cash ate 10 )(Check# I g8 4)? D. Amount Paid )1001 208001 Sales Tax )1501 322900 Garage Sales )1501 341920 Copies/Bid Specs. )1501 341910 LDC/Code of Ordinances )1501 341930 Election Qualifying Fees 31010 343800 Cemetery Lots r CO Y1 L. Lot/Niche Block Unit D1501 343805 Cemetery Fees 50 Initials Whits Dept. of Origin Yellow Finance Pink Applicant Total Paid 50.00 Mary Ann Zarcone Steele STEELE Mary Ann Zarcone, 72, of Palm Bay, died Tuesday, September 22, 2009. Arrangements by Davis- Seawinds Funeral Home, Melbourne Name -1 1 Unit Block s Lot 1 /r. Date of Mark -out Date of Burial' i Time Name of Funeral Ho Authorized by Unit 4 Block 41 Lots 13 14 Deed 1287 Receipt 634 Americo Zarcone Interred 7/20/90 Lot 14 Matilda Zarcone 8600 U.S. Hwy 1 Lot 98 Sebastian, F1 32958 Paid by CEMETERY Receipt No 6 3 4 Dated 7 9 0 Lots 13 14 NO. 800 Block 41 List Price Maximum No. Burial spaces Unit 4 Net Paid 800 Monument permitted Matilda Zarcone 1287 8600 U.S. Hwy 1 -Lot98 Americo Zarcone interred 6/20/90 Sebastian, FL 32958 Lot 14 (Data above this line for City Record only) Name Date CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501 341910 LDC/Code of Ordinances 001501 362100 Community Center Rent 001501 362100 Yacht Club Rent 001501 362150 Non Taxable Rent 001501 343800 Cemetery Lots 601010 343800 Cemetery Lots Lot/Niche Block Unit 001501 369400 Interment ee 1/ 14 W 001501 369400 Weekend Service 680800 220681 Yacht Club Security Deposit 680800 220682 Community Center Security Deposit 680800 220683 Riverview Park Security Deposit t i %%L4t 1525 Cash AmountPaid 7s vd i o r Total Pald 75:06 Initials White Dept. of Origin Yellow Finance Pink Applicant it, ak S 0'4 N Z ate f 31 kc .4 1 L August 2, 1990 Mrs. Matilda Zarcone 8600 U.S. Hwy. 1, Lot 98 Sebastian, Florida 32958 Dear Mrs. Zarcone: Very truly yours, )27 i'/' yez u -vv Kath 'n M. O'Halloran City Clerk KMO j s enclosure City of Sebastian POST OFFICE BOX 780127 D SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589 -5330 FAX 407 589 -5570 Enclosed is Cemetery Deed No. 1287 for Cemetery Lots 13 and 14, Block 41, 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. 634 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. FROM: Witness RECEIPT IS HEREBY ACKNOWLE Shoo d.5. f i4f 98 3295 on this mcg. day of` 1/,d/ 1990 for the purchase of the following described Cemetery Lot(s) upon[ the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)# Purchase Price: THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida ED OF THE SUM OF: f Block# A ll Unit# 1 Terms and'conditions of sale: Dollars hQ Q() 860, �/4 ,DD, t'Do11ars($ )600,5) 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: X7iii4/71 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. City of Sebastian 3y t AMERICO ZARCONE 10-83 MATILDA ZARCONE 8800 U.S. HWY. 1, LOT 98 SEBASTIAN, FL 32958 Pay to the l Harbor Federal FT. PIERCE. FLORIDA 34950 -4393 t 1 I. 26 7oat: 2060000067476o 067'2 I)ollars r' I$ u 672 c I Name of First Middle Last Deceased Matilda Zarcone Date Month Day Year of Death Feb. 22 2003 2. Place of Death City, Town or Location County 3revard Melbourne Name of (If neither, give street address) Hosp. or Inst. Mariner Health of Melbourne 3. Name of Medical Certifier John Potmomski, D.O. fMedical Examiner jPhysician Address 724 E. New Haven Avenue Melbourne, FL Phone Number 321- 724 -4545 4. Name of Funeral Homeakeet-DISMIT Establishment ;trunk Funeral Home Address 1623 N. Central Ave. Sebastian, FL Fla. Lic. No./Reg. No. 1228 Phone No. (Area Code) 772- 589 -1000 B. 5. Check Appropriate Box 6. Funeral Director/ Direct Disposer Approval Number: PE a. b. DH 326, 8/97 (Obsoletes ell previous editions) (Stock Number. 5740. 0000326 -2) State of Florida, Department of Heal h, Vital Statistics APPLICATION FOR BURIAL TRANSIT PERMIT The medical certification has been completed and signed. A completed certificate of death accompanies this application. Marcie was contacted on 2/24/03 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Potomski will complete and sign the medical certification of cause of death within 72 hours. icel ifi kj' of cause of death within 72 hours. was contacted on He/she verified that F.E. No. /Reg. No. Date Signed 1862 2/23/03 BURIAL TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 03-0091 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. ONo extension of time for filing the death certificate has been requested. Registraz.or Date Date Certificate Subregistrar Signature M Issued: 2/22/03 Due: 2/27/03 c. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA 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. CEMETERY OR CREMATORY Place of Disposition Sebastian Cemetery Medical Examiner, will complete and sign the D. Method of Disposition: BURIAL STORAGE Date of Disposition 0 ,?/2 7/Q S CREMATION DOTHER (Specify) Signature of Sexton or Person -in- Charge ,p 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. Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar