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HOME Of PELICAN ISLAND
Certificate No. 2056
C.' "I.'IT' ,..e '"," O' 'F",' S'" .E",,'fi A.S' ',T' .' '1 AN" i
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Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Miguel Quinones
(name)
467 Arbor Street, Sebastian, Fl 32958
(address)
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in and for consideration of the sum of $1.400.00 is entitled to full interment rights in
the Sebastian Municipal Cemetery for the following plot:
Unit_4_Block_30_Lot(s)Niche(s)_3 & 4_
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescribed therefore by the City of Sebastian.
CONVEYED THIS 19th of December, 2005.
ATTEST:
~4?~ -
ly Maio, MMC
City Clerk
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Name ,J () R :r 5
Qu:tf\~ ONES'
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Unit
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Block
Lot
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Date of Mark-out j J - ! l -- ().!J
Date of Burial
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Time
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Name of Funer,alHqme', "it-tj
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Authorized by
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PALM BAY
Doris Quinones
Doris Quinones, 79, died
Dec. 18, 2005, at Holmes, Re-
gional Medical Center i,n Mel-,
bourne. '
She:wasborn in ~anta lsa-
bel"Puerto Rico, and llvedin
, PabpBay forsixmontlls, com-
ing trom Sebastian" " ,.
, She.was ahQtnemaker;
She Was 0(, th~ PE!ntecostal
faith. ·
Survivors, .in~ude. her.hus-
, band of 49 YearS,RufmoQui. '
nones of PalIn 'l3aY; sons, Jose .
River~ ofl:lrQOlUyn,N~Y"and
'Migtl~QuinoneS'6f Sebastian;
da~ters, Santa Vazquez of
Se1Ja.$tlan,.,Norma Guerrero of
, LotlgIsland, N;Y., ,and Florita
WlUIlen of Staten Island, N.Y.; .
12grandchi1dren; aIld,' several
great-grandch.ildren -and
grea.t-grEiat-grandchUd1"en.
SERVICES: Visitation will be
from 2 to 6 p,m. Dec. 20 at, Sea-
Winds Funeral'Home ,SebaS--
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tian. Agraveside' service' Will
be at 10 a.m. Dec. 21 in theSe--
bastlan CemeterY with.' the
Rev. Eliseo Rosario officiating.
Cotldolences may be sent
through www ;sea winds
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State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
f-.Io- tJ,/
FLORIDA DEPARTMENT OF
A.
1 . Name of
Deceased
(TYPE)
First
Middle
Last
Date
of
Death
(If neither, give street address)
Month Day
12/18/05
Year
DORIS
QUINONES
2. Place of Death
County
City, Town or Location
NAVE EN KUMAR, MD
Medical Examiner X Physician
4. Name of Funeral HomelDirect Disposal Address
Establishment SEAWINDS 735 FLElvllNG STREET
FUNERAL HOME & CREMATORY SEBASTAIN, FL 32958 2617 (772) 589-1933
5. Check a. [] The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
Address
675 S BABCOCK ST.
MELBOURNE, FL 32901
Name of
Hosp. or
Inst. HOLMES REGIONAL MEDICAL CENTER
Phone Number
BREVARD
3, Name of Medical
Certifier
MELBOURNE
321-768-0083
Fla. Lic. No.lReg. No. Phone No, (Area Code)
b. 0 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.
c.D
was contacted on
He/she verified that
, Medical Examiner, will complete and sign the
Permission is hereby granted to dispose of this body. Permit No. 05-2617.J.92
I!] 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.
o No extension of time for filing the death ce
Registrar or
Subregistrar Signature
'-
. No.lReg. No.
3114
Date Signed
12/19/05
6. Funeral Director/
Direct aisposer
8.
BURIAL - T
Date
Issued:
12/19/05
Date Certificate
Dl/e: 12/26/05
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.
Method of Disposition:
CEMETERY OR CREMATORY . to "T":
Place of Disposition Sf b /}S Tr;4-11) L E tlVt f I fJ<. y
---
Date of Disposition / ;;. - 7/ - ;;.,.0 06
~BURIAL DSTORAGE
DCREMATION
Signature of Sexton
of~.:~';:"~1I1-in-~
DOTHER (Specify)
} ,~f;~
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T~is. 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.
OH 326, 8/97 (Obsoletes all previous ed~ions)
(Stoel< Number. 5740-000-0326-2)
Oistribution: White: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar
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