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Home My WebLink About4-41-31Q1Y OF HOME OF PELICAN ISLAND 1225 MAIN STREET, SEBASTIAN, FL 32958 (772) 589-5330 April 14, 2014 Anne O'Brien 670 Nobles Street Sebastian, FL 32958 RE. Intennent Rights to Unit 4, Block 41, Lot 31 Dear Ms. O'Brien: Enclosed is City of Sebastian Certificate 2416 entitling you to full interment rights in Unit 4, Blk 41, Lot 31. Also enclosed is a copy of the codes governing the Cemetery. If we may be of further assistance, please do not hesitate to contact Jeanette Williams at 388- 8215. Sincerely, Sally A. aio, MMC City Clerk Enclosure Certificate No. 2416 CITY OF SERASTUN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Anne O'Brien 670 Nobles Street Sebastian, FL 32958 In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4, Block 41, Lot 31 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk. for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 14th day of April, 2014. CITY OF SEBASTIAN, FLORIDA Jos ph . G " in City Manager ATTEST: IYP Sally A. KA,, MMC City Clerk City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. Name(s) 3/. Address jAz,,Mx'r'_� -/�' 3296B Area Code & Phone Number wy'&�mmw' Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: 614444Z ho �o oSO Dollars{$ �2�) on this — day of4� "f'r , 20 for the purchase of the following described Cemetery Lot(s) and/or Niche( ). Unit , Block , Lot(s) 3 / Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. .1jdUC) 6 Additional Fees paid at time of purchase: Corner Markers (set of 4 - $20) Opening & Closing Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation Signature of Purchaser 1: %W W-DATA\Ms-Cemetery\RECEI PT.doc Interment /W O H Circle One Disinterment 0,1-* 7dQ/ TOTAL $ °� 00 City of Setuistian The following documents were provided as Proof of Residency: and NoS(>o CRY OF SEBASTIAN CITY CLERK'S OFFICE 4864 nefkclnr Name No. 001001208001 001501 322900 001501341920 001501 341910 001501341930 601010 343800 001501343805 ii -Check # 7601 Amount Paid Sales Tax Garage Sales CoplesMid Specs. LDC/Code of Ordinances Elm*n Qualifying Fees Cemetery Lots /Dd� LoMiche �, Block 7 . Unit Cemetery Fees --4 Total Paid ' initials �- White — Dept. of Origin • Yellow — Finance • Pink . Applicant 12/17/2014 12:22 Aug 24 2011 10; 33AM MP LASERJET FAX city of sebcr.s ill %pOsstivis Cr► 3mm, Pb- r It M 15d'► • is+s 1'0'. N toI.,Ills -4042? yule : TkItIv for v sict,ait►:rn ('e0-wIc« l'b1► Ir ri►r tilrxta Aftrhvrr mrid cc oti•cr !I).( torr 1 ft. I% a twnacco foou►►danon l #3943 P.001/004 0. ,. Mrul-e rclurtt to s cler of Sat4ytlan L� Dry Mix .Ub91f!an Crowlery 6 1911 worth (rolfo) A%e. h'r�adati��rt t,•• rr+) 3�ySA ,+►i1tAl(tltl �� ('et+trl�rti S'fxl4A � dSfc x �r►, : 500 ��HKs• Nr, . Jr) bn D3).0.17. .._.,.�,....-.�. � Legal00Sollpllfon Unit 4 Lo squalit Apprdyed By cdi ckoa sy : .Ou IiAj% . f . ar = �Y►iA:pfa STRUNK FUNERAL HOME & CREMATORY 1 623 No. Central Ave. SEBASTIAN, FL 32958 . (772) 589-1000 JOHN O'BRIEN August 10, 1933 - April 6, 2014 Mr. John A. O'Brien, 80, died April 6, 2014 at VNA Hospice House in Vero Beach. He was born in Newark, New Jersey and lived in Sebastian for 30 years coming from Gouldsboro, Pennsylvania. He retired from Exxon Corporation as a Gas Station Manager. Survivors include wife Anne E. O'Brien of Sebastian, sons John A. O'brien of Mt. Pocono, Pennsylvania and John Dill of Stockholm, New Jersey, daughters Diane Debella of Effort, Pennsylvania, Liz Sita of Jersey City, New Jersey, Peggy Cutrie of West Caldwell, New Jersey and Nancy Matos, 21 Grand Children and six Great - Grandchildren. He was preceded in death by his son Thomas O'Brien. IRAN .� Unit Block Al t Lot Date of Mark -o Date of Burial :!Z / /// Name of Funeral Home 5 /6s ' Authorized by Time 4o ' oO La",Q FUN, ERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR 13URIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY . 5E tAN %OMs a PILKAM rLmO 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: ADDRESS: PHONE #: (C ck One) gPEN BURIAL LOT Lot Block yl Unit _OPEN CREMAINS LOT Lot Block -Unit PEN COLUMOARIUM NICHE Niche Block Unit � � W BURIAL DATE AND SERVICE TIME: FOR DECEASED: rva e � NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide pr per documentation of ownership) . Name Signature Date I certify that I have determined the ownership of the above described site that all site fees and administrative fees ha4e been paid and authorize opening of same NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR. , V , I-A . Name 'Signature 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 that all fees have been paid Cemetely Sexpn Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. r •, FOHN 61�L4F' ,�' State of Florida, Department of Health, Bureau of Vital Statistics LT BURIAL TRANSIT PERMIT DATE PRINTED: April 7, 2014 TRACKING NUMBER: 2014051606 DECEDENT INFORMATION ased Da te of Death IEN April 6, 2014 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH VNA HOSPICE HOUSE Name and Address of Funeral HomeiDlrect Disposal Establishment Fla. Lic. NoJReg. 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./Reg. No. TIMOTHY W. MARVIN F022789 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: 2014- FO41 8 711-5 05 9 • G /� -t Date Issued: April 7, 2014 Meade Grigg, 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: 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 QTY OF 51r:BASUL HOME OF PELICAN ISLAND 1225 MAIN STREET, SEBASTIAN, FL 32958 (772) 589 -5330 April 14, 2014 Anne O'Brien 670 Nobles Street Sebastian, FL 32958 RE. Interment Rights to Unit 4, Block 41, Lot 31 Dear Ms. O'Brien: Enclosed is City of Sebastian Certificate 2416 entitling you to full interment rights in Unit 4, Blk 41, Lot 31. Also enclosed is a copy of the codes governing the Cemetery. If we may be of further assistance, please do not hesitate to contact Jeanette Williams at 388- 8215. Sincerely, Sally A. aio, MMC City Clerk Enclosure Certificate No. 2416 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: Anne O'Brien 670 Nobles Street Sebastian, FL 329SS In and for consideration of the sum of $1,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4, Block 41, Lot 31 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 14th day of April, 2014. CITY OF SEBASTIAN, FLORIDA Jos ph . G " in City Manager ATTEST: Sally A. Ma1b, MMC City Clerk ari of HOME OF City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. a,Ajq-z 0 " Name(s) o N�61.j 3/. Address j� . 6 32968 Area Code & Phone Number Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt its acknowledged in the sum of: Z�° vo Dollars ($ / / ) on this day of , 204 for the purchase of the following described Cemetery Lot(s) and /or Niche( }. Unit �4 , Block �/, Lot(s) 3 Niche(s) for use in accordance with the conditions, ordinances, resolutions, rules and therefore by the City of Sebastian. 1 '000 g �f �joho- Corner Additional Fees paid at time of purchase: J`� °-° G�' Markers (set of 4 - $20) Opening & Closing Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation Signature of Purchaser Interment regulations prescribed /W O H Circle One Disinterment C/L LL * 7a°/ TOTAL $ 1i 029) 00 a, )W City of Sebdstian The following documents were provided as Proof of Residency: I:\WW- DATAWIs- Cemetery\RECEIPT.doc I and CITY OF SEBASTIAN CITY CLERK'S OFFICE 4864 RECEIPT Name �L tf) ❑ Cash Date y �� [+- Check# 76 01 No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC]Code of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots LotfNiche � U -,Block 7� Unit 001501 343805 Cemetery Fees Q� Total Paid ' / Z'2) Initials White — Dept. of Origin • Yellow — Finance • Pink - Applicant Titg of #Phastiau (frmptery Derb NO. 1295 THIS INDENTURE MADE 11h .... 2,1St........... day of ..... S2p .tEmbeT ........................ A. D., 19.9 Q., between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and Frances Van De Venter 1138 Breezy Way ;.. Apt....# 3C ........................... ............................... ................................ Sebas.tian,.- F1o.rida 3295.8............................. ............................... of the County of ..Indian ..River ..................... anal State of ..... Florida ...... ... ... ... as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of $ 4 N . 0 0 ... .. , ...... 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 .. her heirs, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to -wit: All of Lot(s)31. , 3. Z , Block, .4.1... , , 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. Se-lo 6#04` T 017-X 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 dded 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. Attest.:. D�.'. ......... City Clerk Signed, Sealed and Delivered in thw�esence of: /I/ �_AKAM� STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN, FLORIDA May (aug Seal) I HEREBY CERTIFY, That on this .....21st .............day of ...... Septembe• r •.............................. 19.9a 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 Frances Van De venter ........................................................................................................ ............................... ......................... ............................... 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. ................. lVot Public, State of Florida at Large. My ommission expires F5, ;e; NkAc, sm, o cl Nor'60 Bonded Tnru T rcy Foin - ;,- 'urence inc. VAN DE VENTER, FRANCES 1138 Breezy Way, Spt. #3C DEED #1295 Sebastian, Florida 32958 Lots 31,32 Block 41 Unit 4 r< March 29, 2002 Frances Van De Venter Smith 3246 John Bartram Place Mt. Pleasant, S.C. 29466 Dear Ms. Smith: Enclosed please find City of Sebastian check number 045767 for $200.00 for the sale of Lot 31, Block 41, Unit 4 back to the City of Sebastian, which is the amount paid for the lot when purchased in September, 1990. Also enclosed is a certified copy of Cemetery Deed number 1295 for Lot 32, Block 41, Unit 4, which you still own and where William Van De Venter is interred. If you have any questions, please contact our office. 7 S' ly, 'o * Sally A. Wo, CMC City Clerk SAM js enclosures CERTIFICATION STATE OF FLORIDA COUNTY OF INDIAN RIVER CITY OF SEBASTIAN I, Sally A. Maio, City Clerk of the City of Sebastian, Indian River County, Florida do hereby certify that the attached is a true and correct copy of Cemetery Deed Number 1295 showing that you still own lot number 32 but sold lot 31, block 41, unit 4 back to the city for $200.00 which is the amount you paid for it in September, 1990.. IN WITNESS WHEREOF, I hereunto set my hand and affix the Seal of the City of Sebastian Indian River County, Florida, this 29th day of March, 2002. City Clerk L C n /m 3 R .y } O z 0 a C. 0 Q w cu fu U O Q Z w z Nt �. Z •_ a z U r U) w x Lu U t, j e i _.. . Qf co a c o x z In c to s Jr ID > F z � I.! rG r •• L o 5 ru z m -, ' O n . C. _ C. • CU Q Q O z x :. Lo a cu �t z cu o ' M C. d -z M SE V- IA EfJ C- `# D Cu rrn^ C • V J W ;.} w rr�� 4 W f3 .1 En lb z u z: Q z F?, CL • CIO O IM U cc s.. 0L d-+ . — A r co�¢Q 0 c�c r- _, W J C ip r E W W iL ai" U u- V �'t yk �. cu h- LL My- LL o a V, ul cc a �o a ° o O Im ru O rm O vi O cc O .a O O ■ •• C�- O LD O O r— L O rJ3 r- Ln J O CITY OF SEBASTIAN CHECK REQUEST Accounting Use Only Input Date Fiscal Period Document # Entered By Document Amount # of Lines Total HC Hash To Be Compl ed By Department Due Date Single Check Y N Vendor Number IN TC Document Reference Organization Code Object Code Project Code Amount Number of Lines Amount „ ev Description ISSUE C CK TO Ht NAME ADDRESS 'xl'tj /O` CITY E FATE S . G' j ZIP CODE DRAW CHECK FRO APPROVED BY JDATE Q BUDGET APPROVAL (534000 AND 535450 ONLY) I� MAIL ATTACHED DOCUMENATION (Except for remit slips, requesting department should attach a copy of documentation along with riginal) OTHER INSTRUCTIONS Q1.4 'ev -'0 P City of Sebastian POST OFFICE BOX 780127 ❑ SEBASTIAN, FLORIDA 32978 TELEPHONE (407) 589 -5330 ❑ FAX (407) 589 -5570 September 24, 1990 Frances Van De Venter 1138 Breezy Way, Apt. #3C Sebastian, Florida 32958 Dear Mrs. Van De Venter: Enclosed is Cemetery Deed No. 1295 for Cemetery Lots 31 and 32, 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. 643 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 Kathryn M. City Clerk KMO : j s enclosure yours, O'Halloran -0) a -oa -6 .� THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: !JA —#jJA Dollars ($ on this day of 19fd for the purchase of the following described Cemetery Lots) upon the terms and conditions as stated herein: Description of Property: Cemetery Lot (s) # Block# Unit# Purchase Price:_"—r"") Z� y DbZlars($.4� ) Terms and'conditions of sale: 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. �✓ of . astian I�� 1� i