HomeMy WebLinkAbout4-34-11Name
Unit
Block
Date of Mark -out '{ /
Date of Burial ,rya v Time
Name of Funeral Home S u hl
Authorized by
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 4387
RECEIPT
Name 0— o Cash
Date �" ' ,`Check # 61tq
No. Amount Paid
001001
208001
Sales Tax
001501322900
Garage Sales
001501
341920
Copies /Bid Specs.
001501341910
LDCICode of Ordinances
001501341930
Election Qualifying Fees
601010
343800
Cemetery Lots
22 //''
LoWiche Block, Unit
001501
343805
Cemetery Fees
Total Paid / Q• U
Initials
White — Dept. of Origin • Yellow — Finance • Pink • Applicant
VIVIAN J. PLAYER
Miss Vivian J. Player, 92, died May 22, 2013 at VNA Hospice
House in Vero Beach. She was born August 5, 1920 in
Inwood, NY and lived in Micco coming from Northport, NY in
2000.
She received her Master's from St. Johns University in New
York in nursing and received her Masters in Physiology from
New York University. She retired as the Administrator of
Nursing with the VA Hospital in Northport, NY after 30 years.
She then taught Nursing at the State University of New York
at Farmingdale, NY. She attended First Baptist Church of
Barefoot Bay.
Survivors include nephew, Peter W. Player and wife, Andrea
of Micco and three great- nieces and a great- nephew. She
was preceded in death by brother, James Warren Player, Sr.
and sister -in -law, Etta S. Player.
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
Ma
HOME CF FEUCAN ISWO
For information contact:
IGp 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:
STF'fi�P K FUNERAL HOME & CREMATORY
ADDRESS: SEBAS I "IAN, FL 32958
(772) 589-1000
PHONE #:
(Check One)
OPEN BURIAL LOT I Lot Block Unit
OPEN CREMAINS LOT Lot Block Unit ��
OPEN COLUMBARIUM NICHE Niche Block Unit
N
BURIAL DATE AND S RVICE TIME:
FOR DECEASED: 1 a -j
Name
NAME AND SIGNATURE OF LOT OWNER OR REP ENTATIVE:
(Must provide proper documentation of ownership}
�� W . � I aty � �1 I
Name nature 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.
ME AND SIGNATURE OF LICENSED FUNE DIRE TOR:
l ►^rl tiJ . I�IG �12I i�
Name ignature Date
Cemetery Sexton Certification:
certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office an zd that all fees have been paid:
Ce to Sexton Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
15LOXIDA DMAKIMEff OE'. ,. State of Florida, Department of Health, Bureau of Vital Statistics
HEAL T BURIAL TRANSIT PERMIT
DATE PRINTED: May 23, 2013 TRACKING NUMBER: 2013076417
1. DECEDENT INFORMATION
Name of Deceased Date of Death
VIVIAN J PLAYER May 22, 2013
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 Home /Direct Disposal Establishment Fla. Lic. No. /Reg. 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: 2013- F041870 -5084
't Date Issued: May 23, 2013
J
Meade Grigg, State Registrar
3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION
Authorization given by Medical Examiner District 19 Approval Number:
4. CEMETERY OR CREMATORY
Place of Disposition: VERO BEACH CREMATORY
Method of Disposition: CREMATION Date of Disposition: O
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
it
Paid by CEMETERY Receipt No..
List Price $....1. 500: 00
1,500.00
Net Paid $ ..................
85. ......... Dated ..... 4�3�95 ............. Lots 11 & 12 NO.
•
BlocAw
ri1 n i tw
Maximum No. Burial Spaces ................. U jJ t
Monument permitted ............ J
(Data above this line for City Record only)
Tug of #Phas#ittn
TrutPtrrjj 19rrb NO.
THIS INDENTURE MADE Thb .....3r...... day of .... April ............................... A. D., 19.9.5..,
between llte City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and
......... ......................Jalne.s.. W ....PZ ay.e.r., . J r ............................... I .......................
9985 88th Street
............. ...........................Vero Beachy-T-lor•i•da -32.967. ........... ...............................
of the County of .. Tp# an..Riyer ...................... an'l State of ......... Uptr. i. da..................................
as Grantee, WITNESSETHt
That the Grantor for and in consideration of the sum of $ ...l.r. 5.00 ; OO , 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 , . h 1 S . , heirs, legal representatives and assigns
the following property situated in Sebastian, Indian River County, Florida, to -wit:
AB of Lot(s) 1 !A 1.2. Block, ..... 34 , 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 inch 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.
CITY
OF SEB N, FLORI
Attests` .!' l....................... ....... B ................. ...............................
City Clerk Mayor
gne_1 d and Delivere�
n the, ence oly
...�...�...... ....... (MUL) cSeal)
.. ................
STATE OF FLORIDA
COUNTY OF INDIAN RIVER
I HEREBY CERTIFY, That on this ........ra ..............day of ............ April .............................� 19 95
before me personally appeared ....Arthur L. Firtion .... and .Kathr.yn M. 0!,Halloran
respectively Mayor and City Clerk of the City of Sebastian, a municipal corporation under the Iav's of the State of Florida to line known
to he the individuals and officers described In and who executed the foregoing conveyance to
....................... ........................Tames.. W. ... pl aye.r., .. J. r.. ........... ..........................................
......................... ............................... and severally acknowledged the execution thereof to be their free act and deed
as such officers thereunto duly authorized; and that the Official seal of said corporation is duly affixed ncreto, and the said conveyance
is the act and Bred of said corporation. /
WITNESS my signature and official seal at Sebastian, In the lunty ofI.disc River o9d tat o�l+I�ida, the day and yea;
last aforesaid. /
LINfA M. GALLEY M: June 1 19 996 No Public "(/.I-111 a MY l�1MM16811" 9 lx ty rg
9mOSSLwNasryPu*udWrsshn My Commission Cxpir st
Linda M. Galley
• A' WE SEBASTIAN CEMIPER Y �� 6 0
CITY OF SEBASTIAN, FLORIDA
IPT IS HEREBY ACKNOWLEDG D OF THE SUM OF:
/ Dollars ($ Q. )
FROM:
on this � day of 19 for the purchase of the
following described Cemete y Lot(s)/Niche(s) upon the terms and
conditions as stated herein:
Description of Property:
Cemetery Lot( s) s) Block Unit
Purchase Pric Dollars
Terms and Condition 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_(,W or# -the terms and conditions stated in the
above instrument. c
itness Ci 'y of Seb st ' an
l
April 10, 1995
City of Sebastian
1225 MAIN STREET El SEBASTIAN, FLORIDA 32958
TELEPHONE (407) 589 -5330 o FAX (407) 589 -5570
Mr. James W. Player, Jr.
9985 88th Street
Vero Beach, Florida 32967
Dear Mr. Player:
Enclosed is Cemetery Deed No. 1497 for Lots 11 and, Block 34,
Unit 4.
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. If you wish to have this deed
recorded you may do so at the office of the Clerk of the Circuit
Court, 2000 16th Avenue, Vero Beach, Florida, 32960.
We are enclosing two copies of Receipt No. 850 and ask that you
sign and return to us the copy marked with an "X" and retain
the other copy for your records. The previous receipt you
received had an incorrect Block number listed. A stamped,
self- addressed envelope is provided for your convenience.
Very t my yours,
Kathryn M. O'Halloran
City Clerk
KMO:lmg
enclosure
( \ws- form- cem.rec)
Name TTA
Unit
Block
i I ()Cc
Date of Mark-out
Date of Burial Time
v
Name of Funeral Home—',--.,/
Authorized by
73
Total Pail!- �✓
als
White - Dept. of Origin a Yellow - Finance • Pink - Applicant
CITY OF SEBASTIAN
CITY CLERK'S OFFICE 3680
RECEIPT
Name
t
❑ Cash
Date
I In
Check # 58 7
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
LotMiche 1 1 j Block
Unit
.
001501343805
Cemetery Fees
0/c, =50 0
Total Pail!- �✓
als
White - Dept. of Origin a Yellow - Finance • Pink - Applicant
i
I
�^
; I
wr- -
'��
I
MA S. PLAYER
Mrs. Etta S. Player, 81, of
Malabar, FL, died Sunday,
November 12, 2006, at her
residence.
She was born September
20, 1925 in Queens, New
York, and moved to Malabar
36 years ago, from Inwood,
LI, New York.
Mrs. Player was a
Supervisor at Health South
in Vero Beach for 18 years.
Surviving are her son,
Peter (Andrea) Player of
Micco, Florida; sister, June
Werner of Pinehurst, North
Carolina; stepsister, Catz
Woods of East Rockaway,
NY; sister -in -law, Vivian
Player; 4 grandchildren,
Tammy, Rachel, Jenny &
Brandon; 12 great-grandchil -
dren; 1 great- great- grand-
child. She was predeceased
by her husband, James W.
Player; and her son, James
W. Player, Jr.
SERVICES: A visitation will
be held from 6 -8 p.m.,
Thursday,November 16, 2006
at the Strunk Funeral Home,
Sebastian, FL.
A funeral service will be
held 11 a.m.,Friday,
November 17, 2006 at the Fu-
neral Home Chapel, FL with
Rev. Richard Phipps
officiating.
Interment will follow in
Sebastian Cemetery,
Sebastian, FL.
Please call with cost to run
this obit as a paid in the
Press Journal, David is
taking a picture to the Pi
i
office n Sebastian that is to
run with this obit.
Paid Obituary
FLORIDA DEPARTMENT OF
HEALT
A. (TYPE)
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
�.—� U1 Mrst Middle Last Date Month Day Year
Deceased
of
Etta S. Player ' Death Nov. 12. 2006
2. Place of Death
County
Brervard
t,lry, I own or Location
Malabar
o. Name or medical
Certifier Salidj S• Qaiser, M D.
Medical ExaminerPh
4 N
Name of (If neither, give street address)
Hosp. or
Inst. 2936 Century Oaks Circle
17 Phone Number
50 Cedar Street
Rockledge, FL
321 - 633 -1981
ame of Funeral Home /Glrest- Brs}�vsal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code)
Establishment 1623 N. Central Ave.
Strunk Funeral Hdme Sebastian FL
5. Check a,
Appropriate
Box
b.
c. ❑
6. Funeral Director/
�r
• 1228 772- 589 -1000
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
was contacted on
He /she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that will complete and sign the medical
certification of cause of death within 72 hours.
medical
of
was contacted on He /she verified that
, Medical Examiner, will complete and sign the
within 72 hours.
all F.E. No. /Reg. No.
""'� 1862
// /l.t
B. BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228- 06-0441
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.
� Date Date Certificate
Subregistrar Signature Issued: 11/12/06 Dye: 11/17/06
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 DSTORAGE Date of Disposition
OCREMATION
Signature of Sexton
or Person -in- Charge
OTHER (Specify)
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, 8/97 (Obsoletes all previous editions) Distribution: White: Cemetery or Crematory
(Stock Number. 5740 -000 -0326 -2) Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar ANKW 4* P.P.
Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1
ETTA S. PLAYER
Viewl&gn Guest Book
ETTA S. PLAYER Mrs. Etta S. Player,
81, of Malabar, FL, died Sunday,
November 12, 2006, at her
residence. She was born September
20, 1925 in Queens, New York, and
moved to Malabar 36 years ago,
from Inwood, LI, New York. Mrs.
Player was a Supervisor at Health
South in Vero Beach for 18 years.
Surviving are her son, Peter
(Andrea) Player of Micco, Florida;
sister, June Werner of Pinehurst,
Published in the TC Palm from 11/15/2006 - 11/16/2006.
Notice • Guest Book • Flowers • Gift Shop • Charities
Today's TC Palm obituaries and death notices
Questions about obituaries and death notices or Guest Books?
Contact Legacy.com • Terms of use
Powered by Legacy.Com
obituaries nationwide
Back
http: / /www.legacy. comltcpalmlObituaries. asp ?Page= LifeStoryPrint &P ersonID= 1992... 11/27/2006