HomeMy WebLinkAbout4-30-07
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HOME 01' PELICAN ISLAND
Certificate # 1973
CITY O,!f SE,BJAST1AN
-.- - - ... _..-- -.... ..- -- -- ------
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Joseph Calcagno
(name)
865 Barber Street, Sebastian, Fl32958
(address)
in and for consideration of the sum of $700.00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plots:
Unit_ 4_ Block _30_ Lot_7 _
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 13th day of July, 2004.
AT.+EST:
. ~/',?Ilm~
,,____/ -(..-0 v- v Fe - " 'I'
/~ally A. Maio, CMC
City Clerk
~SA
Terrer..tceR. Moore
City Manager
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A
Anna Calcagno, #Jo/l> 7
Sebastian
Anna Calcagno, 77, of Sebastian,
died July 9, 2004, at Bethesda Me-
morial Hospital in Boynton Beach.
Mrs. Calcagno was born Jan. 2,
1927, in Astoria, N,Y., and moved to
Sebastian from Fort Lauderdale 14
years ago.
She was a homemaker and an
avid bingo player.
Surviving are her husband, Jo-
seph; sons Joseph Calcagno, of
Plantation, Santo Calcagno, of Rio
Rancho, N,M., Anthony Calcagno,
of Tallahassee, James Calcagno, of
Loxahatchee, and Dominick Cal-
cagno, of Dania; brothers Dominick
Mariano, of Ocala, and Gerald Mar-
iano, of Lake Placid, N,Y,; and 11
grandchildren.
SERVICES: A graveside service
was held July 10 at Sebastian Cem-
etery, Sebastian.
Arrangements are under the di-
rection of Seawinds Funeral Home
CllYOF
SEI!~S:r
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HOME OF PELICAN ISLAND
1225 Main Street, Sebastian, FI 32958
Telephone (772) 589-5330 - Fax (772) 589-5570
July 13, 2004
Mr. Joseph Calcagno
865 Barber Street
Sebastian, FI 32958
Dear Mr. Calcagno:
Enclosed is City of Sebastian Certificate 1973 for the purchase of Cemetery Lot 7, Block 30,
Unit 4, Also enclosed is a copy of your receipt and the Rules and Regulations governing the
Sebastian Municipal Cemetery,
If you have any questions, please contact our office.
:];{~C?)J;
Sally A. Maio, CMC
City Clerk
----
SAM:ar
enclosure
SEBAST!AN
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HOME OF PD.ICAN ISLAND
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, residence of purchaser or person for whom lot is intended for interment must be
provided at time of purchase
:ro$ep~ C.P.\CA1""O
Name(s)
€toS P~P.~6t. oS r
Address
-; 7 ;).. - ~ 6 t:t - ...1 (0 4-~
Area Code & Phone Number
jE.~PJSTi~tJ ~l '$2'1SB
,
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
Se< \!,.J hV\ ,..[J I...t:q Dollars ($ -Z 00. 1)..0 )
on this \ 1..- day of 7 v ~ ' 20 E..1- for the purchase of the following
described Cemetery Lot(s) and/o Nlche(s).
Unit ---i-, Block 3d , Lot(s) 7 Niche(s)
,- ".' .
for use in accordance with the conditions, ordinances, resolutions, rules and regulations
prescdbed therefore by the City of Sebastian.
Additional Fees paid at time of purchase:
Corner Markers (set of 4 - $20)
Opening & Closing l 2'::> _ o?
W 0 H
Circle One
Vase and Ring for Niches (cost)
Interment
Disinterment
Signature of Purchaser
yL
f Sebastian
Service fees are to be paid at time of need only
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III 735 FLEMING STREET
!.; SEBASTIAN, FL 32958
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735 FLEMING STREET
SEBASTIAN, FL 32958
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James Young/Sam Coburn
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p. 1
SEA WINDS FUNERAL HO:ME
VITALS STATISTICS
FD: SG C
DATE:
NAME
FIRST
MIDDLE
/Vl.
SEX
DATE OF BlRlH
1-1--2.
PLACE OF DEAlH
_INPAllENT_ERI0UTPATIENT
LAST
C4/C
SOCIAL SECURITY NUMB
12~ - I ~ <~l.u1
BIRTIIPLACE
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AGE
/7
VETERAN YIN
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DOA_NURSING HOME_RESlDENCE_OTIIER
INSIDE CITY YIN
1+2.. d. 1 A.!2 (It JJO
INFORMANTs NAME
JOSt. c~r CA NO
MEnlOD F DlSPOSmON
BURiAL CREMATION REMOVAL
DONATION OlHER - SSAv.h ,JD5
C-cmeTbI?-
r{
DOCTOR ~'\ WE:<, ADDRESS
T.O.D. M ILLNESS SUDDEN BRIEF EXTENDED
CHURCH AFFlLIAnON
WORKED FOR -
CLUBSI AFFLU1A nONS .-- ~ I ""50 . .v I A I i"~ ; ,
BRANCH OF SERVICE
PHONE
WAR
MARRIED 53 YEARS FAMILY PHONE S ~y . 2.1.P 4- 2.
RESIDEm' OF Se~ FOR 14 YEARS COMING FROM
MEMORIAL CONTRIBUTIONS
OTHER. II
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RELATION
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O~ G3N'MfUffiI ON / S3'^-
SL:Jtldd87VNOSN8J
FLORIDA DEPARTMENT OF
!-JI-07
HEALT
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL - TRANSIT PERMIT
A
(TYPE)
1, Name of First Middle Last Date Month Day Year
Deceased ANNA CALCAGNO of
M. Death JULY 9, 2004
2, Place of Death City, Town or Location Name of (If neither, give street address)
County Hosp, or
BROWARD BOYNTON BEACH Ins!. BETHESDA MEMORIAL HOSPITAL
3, Name of Medical Address Phone Number
Certifier JAMES BYRNES, MD 237 GEORGE BUSH BOULEVARD 561-272-5373
nMedical Examiner rxlPhysician DELRAY BEACH, FLORIDA 33444
4, Name of Funeral Home/Direct Disposal Address Fla, Lic, No./Reg, No, Phone No, (Area Code)
Establishment 735 FLEMING STREET 2617 772-589-1933
SEAWINDS FUNERAL HOME SEBASTIAN, FLORIDA 32958
5, Check
Appropriate
Box
a, []
The medical certification has been completed and signed. A completed certificate of death accompanies this
application,
bD
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
medical certification of cause of death within 72 hours.
6, Funeral Director!
Direct Disposer
Signature
FE No./Reg. No,
2294
Date Signed
7/9/04
B,
BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of this body, Permit No, 04- 2 617 -13 4
o 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 /1
[Xl No extension of time for filing the, ~,t7 ce71ficate has been requested,
Registrar or I j II/~" Date Date Certificate
Subreglstrar Signature II ,ILl' Issued: 7/9/04 Due: 7/20/04
IIY
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C,
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
Approval Number:
Date
Medical Examiner, . gave authorization by telephone to
Funeral DirectorlDirect 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,
Method of Disposition
~L
DCREMATION
Signature of Sexton
or Person-in-Charge
DSTORAGE
CEMETERY OR CREMATORY 'a-
Place of Disposition _<)-'c.6 A $;-;>4 r/ ( ;.e: IV") /:./ ;z, ~'i '
I /
Date of Disposition 7 / D It) 'f
D,
DOTHER (Specify)
) ;('0 ? ;(J;?),/
This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral DirectorlDirect 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 editions)
(Stock Number 5740-000-0326-2)
Distribution: White: Cemetery or Crematory
Yellow: Funeral Director or Direct Disposer
Pink: Local Registrar