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Home My WebLink About4-29-30.O. Q11' � � �� ;�. .,s �:.� — HOME OF PEUCAN ISWVD Certificate No. 2013 C; ',T `� � ;� S,�.�,�k�ST'��:N Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Jake Trantham (name) 1313 N. Central Avenue, Sebastian, Fl 32958 (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 plot: Unit 4 Block 29 Lot 30 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 day of April, 2005. CITY OF SEBASTIAN, FLORIDA James A. Davis Interim City Manager ATTE��: ; �'�x�'` ��`� _ r; r ! ��' � � �--- � � - Sall A. Maio, MMC City Clerk �J. �� U � 1 `' �.y« n Name �<< F , :.� E�7 �..; Unit � �: Block � ' M LOt ^�1't `^ , . �. {./ t �4�.4 + F�, .., ;r-"'. �`" �"" � �.y '" ....; ��r Date of Mark-out 1 � :-� i -- d`�a � Date of Burial ``� � '� ��^ .,,;, ,' ��... i.,F a `�,r�' � � Name of Funeral Home �' ' � ; �a,, __ Authorized by , h. ��f4 : 'k Time ± �` �� .� � � ; ' .+', 'r t- ; t ` ;:..i ; t� � �,��` � : , , : . , : �,� ; ��.: ��.�F FLORIDA DEPARTMENT OF ��IiL� A. (TYPE) 1. Name of First Deceased Susan 2. Piace of Death County tndian River � a.p..� State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURI�4L - TRANSIT PERMIT Middle Ann Lewis City, Town or Location Vero Beach 3. Name of Medicai Certifier Richard Cunningh m, D.O. Medical Examiner Physician Last Brock i� Date Month Day Year of Death April 14 2005 Name of (if neither, give street address) Hosp. or i�st. VNA Hosoice House 901 37th Street Vero Beach, FL Phone Number 772-978-5600 4. Name of Funeral Home/�ir�c�B�isposai� Address Fla. Lic. No./F2eg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. Strunk Funeral Home Sebastian, FL 1228 772-589-1000 5. Check a. � Appropriate Box b. c. ❑ �. runeral Girector/ p�est sie,�e�er a. ' The medical certification has been completed and signed. A completed certificate of death accompanies this application. Sharon was contacted on 4/15/05 Ne/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Cunningham w�u �ompiete and sign the medical certification of cause of death within 72 hours. was contacted on He/she verified that / , Medical Examiner, will complete and sign the medical of death within 72 hours. �.E. No.fReg. No. i?+-�1��--� , 1862 BURIf�L - TRANSIT PERMIi Dat� Signed 4/14/05 Permission is hereby granted to dispose of this body. Permit No. ' 22$-05-0166 � 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 withir 72 hours. ❑No extension of time for filing the death certificate has been requested. �r.�« Date Date Certificate SubregistrarSignature Issued: 4/14/05 �ye 4/19/05 .,. AI�THORI�.TI�N for CREMATION, DISSECl'ION9 or BURIAL-AT-SEA J Approvaf 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. Methc� of Disposition: �BURIAL �CREMATIOt� Signature of Sexton or Person-in-Charge �STORAGE �OTHER (Specify) � �� _ C�METERY OI� �REMF�T��' Place of Disposition Sebastian Cemetery Date of Disposition � ��,Q/D S T— This permit must be endorsed by thQ Sexton or psrson-in-charge (or by the Funeral Director/Direct Disposer when there is no Se>:�onj and r°turned �vithin 10 days to the tccal Couniy Health Departmen± in.the county where disposition occurred. �H 326, 8/97 (Obsoletes all previous editions) Stock Numbec 5740-000-0326-2) Distribution: White: Cemetery or Crematory Yellow: Funeral Director or Direct Disposer Pink: Local Registrar NcSrtled �� Poper CffY OF �� , � ��.. . . ;�.�.: °��. .,......��.:: ,, HOME 4F PELiCAN ISiAND 1225 Main Street, Sebastian, F132958 Telephone (772) 589-5330 — Fax (772) 589-5570 April 19, 2005 Mr. Jake Trantham 1313 N. Central Avenue Sebastian, Fl 32958 Dear Mr. Trantham: 10 Enclosed is City of Sebastian Certificate 2013 for the purchase of Cemetery Lot 30, Block 29, 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. Sincerely, Sally A. Maio, MMC City Clerk SAM: ar enclosure �#�oi,a �� HOME 0� 'PEUCAN ISIAhID City of Sebastian Muni�ipal 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 �J � ��F /��5'��`'%l'.9� Name(s) . �,��.� N ��,c�/ �'��,�u� .�S'��-r; �,� ��. .�,z�.�8 Address ; : � -,�s-y -37J�6 Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only is acknowledged in the sum of: �'� ..i / � Dollars ($ %40. � � ) on this day of , 20� for the purchase of the following described emetery Lot(s) a d/or Niche(s). Unit _�_, Block �_, Lot(s) 30 Niche(s for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. Additional Fees paid at time of purchase: � Corner Markers (set of 4-$20) Opening & Closing �✓� d� W O H Circle One Vase and Ring for Niches (cost) Interment �-� Disinterment Signature of Purchaser of Sebastian � %7� d a TQ�� , , Service fees ar� to be �aid at time of need oni� I:1W W-DATA\Ms-CemeterylRECEI PT.doc �� ', �, �%��:�> / ! CITY OF SEBASTUIN � � � � CITY CLERK'S OFFICE RECEIPT _ �� Name ❑ Cash , Da � Ov eck# � �� No. Amount Paid 001001208001 Sales Tax " , 001501322900 Garage Sales ' 001501341920 CopieslBid Specs. ' 001501341910 LDCICode of Ordinances 001501341930 Election Qualiryi�g Fees 601010 343800 Cemetery Lots / O D• 00 , LotlNiche . Bbck . Unit 001501343805 Cematery Fees %��00 , �� - � �� % ToWI Paid � • �O initials White - Dept. of Origin • Yallow - Finance • Pink - Applicant I . I (n � � �� ► � � �� v � -� � � � (� 6!1 — r/' � � � -� _ � � � � � �qq N O� �� Q�i 0 g � � �� O _ d4 o � � � M � da �� v" �' � � I\ r V 1 \ � � � � v �, m � n �.Q ^ � ==W� �� ~ao` za�� a a�� ''WZ ��, � JQ`U� � c� � Y'��a C� m � o Q.Z m w �-J: J � y7 Jo t� P � N m J J � � � � � �' f=`�� `� M .� [n � — ¢ �� m 0 w N:;. � Z. ¢ ti � ¢ 0 M a" z �Q 1 � � 1• � O O E O � O= ... - .. : 1 ; O - � 0 - �• - a Kip Kelso From: Sent: To: Subject: Dear Mr. Kelso, Joseph Broglio [cybroglio@bellsouth.net] Saturday, July 07, 2012 12:12 PM Kip Kelso Cemetery Information Request My mother passed away almost a year ago. Her burial place is in Louisiana. I just found a receipt for two cemetery plots in the Sebastian Cemetery; Lots 29 & 30, Block 29 Unit 4. This was for my mother, Bertha M. Hensley, and her then husband, Billy A. Hensley. Their address was 581 Futch Way, Sebastian, FL. My name is also on the receipt; Carol Broglio, Bertha's daughter. Since these plots are no longer needed, can I resell them back to the cemetery? My mother and Billy A. Hensley were divorced many years ago and I don't even know if he is still living. I have had no contact with him. Please contact me with any information you can give me. Thank you, Carol Broglio 107 Lichen Lane Lafayette, LA 70507 cybroglio@bellsouth.net Phone: 337-896-9909 ��`� ��Z I� � p wr �l e�h�,� ( rt�ts� ..�rv f��v �v�ol Ief � h� r kn n c� -�Q,+ h e,r m o� e.r �S� f d b crc,k.. -I� e. (o�s �4u� . I 7, �,v o 1 � ..,- C1�Y (�' ��;�� y. �, r�� ..,._.. �:�::., S� HOi11fE aF PEGICI►N iSI1kND August 17, 2001 Ms. Bertha Hensley 874 Grandin Avenue Sebastian, F132958 Dear Ms. Hensley: Enclosed is a City of Sebastian Check No. 43087 in the amount of $1,000.00 for the sale of cemetery Lots 29 & 30, Block 29, Unit 4, back to the city for the dollar amount originally paid October 28, 1998. If you have any questions, please contact our office. S' cer , — ' , ��— :. Sally A. Maio, CMC City Clerlc SAM:js enclosures . 1� � � ;� 1.� : a, � ' 1 ' '► i ' '` NO. i� 28th October 98 THIS INDENTURE MADE Th7a ...................... day of ............................................. A. D., 19......, het�ceen il�e City of Sebastian, a municipel corporation esisting under the laws of the State of Florida, ne Grantor and Billy !�. Hensley and/or Bertha M. Hensley and/or Carol &ro-l�i.o ......................................................................................................................�;:�.G`�-1.�.... 581 Futch Way .............................................g e�b a s t i�a �.�...�L..3 2.�.5 8........... ............................................ of the County oi ..Indian..Rive� ...................... 8��1 Stote of Florida ............ ........................................ ae Grantee, WITNES3ETH: 1 0 � 0• � 0 ,, to it ' hanii aid, the recei That the Grantor for and in consideration of the sum of $ . . . . . . . . . ? . . . . . . . . . . . . . . . u�, e 1 p pt whereof is herewith ac- knowledged, does by this instrument grant, bargain, sell, release, convey and confirm unto the Grantee .� i1 ,,, r, heus, legal representatives and assigns the following property situated in Sebastian, Indian River County, Florida, to-wit: All of Lot(s�,� �C3Q , Block, 2�.. ..., UNIT ...4. .... ... ., of Sebastian municipal cemetery as per Plat Number 1 thereof iecorded 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 iegulations,'otdu►ances 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 de'.ed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall ievert to the City of Sebastian, Florida. IN WITNESS WHEREOF, The said party of the fust pazt 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 heieto afiixed, the day and year fust above written. �� :�G�� Attest: ........... ....................................... City Clerk . Signed, Seeled und Dclivered in the Presence of6 . �.;. �_ .1.�:,�-� . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . �. �. � . . . �� . . . . . . . . . . . . . . . . . . . . . . � STATE OF FI.ORIDA COONTY OF INI}IAN RIVER 28th October 98 I HE1tEBY CERTII+Y, That on this ........................day of ........... ....................................., 19...., Kathr n M. 0 Halloran before me petsonally appettred . . . . . . . . , RlltYl Sul1 ivan . , . . . ana y ..................................... ....................................... respectively Mayor and City Clerk of the City o4 Sebastien, a municipal corporntiun under the law•s of thc State of Florida to me known to be tl�e indivi�luxls and officers described in und who executed tlie foregoing cowveyance to ..........B.i1].�.A.....Hens].e.y..�z�d./.or..Bertha,.M,,,Hensley. and/or Carol Broglio CITY �F SEI3A6TIAN, FLORIDA ��a ` By �.�- ' .. ��C'.�.i ................................ Mayor (cutt� �Y�1) ,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,, and severully acknowledged the execution thereof to be their free act and deed as such officers thereuntu duly authorized; and that the OFficixl seul of snid corpurr�tion is duly uffixed tl�eretu, and the said conveyuncc is the fict und deed of said eorporation. A � �