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Home My WebLink About4-14-32�2) mcmy ortr of Simsy N NOME OF PELICAN ISLAND Certificate # 1893 CrrY OF SE.13 AST I N1 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Warren A. Guthenberg (name) (name) 1127 Breezy Way, Sebastian, F1 32958 (address) (address) in and for consideration of the sum of $1,400.00 , has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit 4 , Block 14 , Lot(S) 32 & 33 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 11th day of April 2003 CITY OF SEBASTIAN, FLORIDA A r / Sa y A. 0, CMC Terrence R. oor/ City Manager City Clerk r._� o: Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1 ELEANORE C. "ELLIE" THOMPSON Eleanore C. "Ellie" Thompson, 81, died Jan. 11, 2009, at Sebastian River Medical Center, Sebastian. She was born in the Bronx, N.Y., and lived in Barefoot Bay for 12 years, coming from Kings Park, N.Y. She was a secretary in the New York Public School System. She was a member of St. Luke's Catholic Church, Barefoot Bay. Survivors include her son, William T. Thompson Jr. of Summerville, S.C.; daughters, Donna Hom of East Northport, N.Y., and Janis Egan of Kings Park, N.Y.; brother, James Soucy of Medford, N.Y.; sisters, Eileen Flock of Venice, Patricia Pueraro of Scarsdale, N.Y., Helen Mungo of Barefoot Bay, Lorraine Guthenberg of Sebastian and Kathleen Simnor of Parlin, N.J.; five grandchildren; and three great - grandchildren. She was preceded in death by her husband, William Thompson; brother, William Soucy, and sister, Marianne Rutzinger. SERVICES: Visitation will be from 3 to 6 p.m. Jan. 14 at the Strunk Funeral Home, Sebastian. A Mass of Christian burial will be celebrated at 10 a.m. Jan. 15 at St. Luke's Catholic Church, Barefoot Bay. Burial will follow in Sebastian Cemetery, Sebastian. Published in the TC Palm on 1/13/2009 Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Powered Eby Legac y.com obituaries nationwide Back htx.1 -5. I- /5 -oq /o vo CLM http:// www .legacy.com/tcpalm/Obituaries. asp? Page= LifeStoryPrint &PersonID= 12278... 1/13/2009 15 A. FIARIDA DEPARTMENT OF HEALT (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of Eleanore C. Thompson Death Jan. 11 2009 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian Inst. Sebastian River Medical Center 3. Name of Medical Address Phone Number Certifier Michael Venazio, M.D. 8005 83rd Avenue Medical Examiner tPhysician Sebastian, FL 772- 388 -2110 4. Name of Funeral Home/DW -- Dispesal Address Fla. Lic. No./Reg. No. Phone No. (Area Code) Establishment 1623 N. Central Ave. trunk Funeral Home 6 Cremat Sebastian, FL 1228 772 - 589 -1000 4. %.rkacn a. U I ne meolcal cerimcaaon nas Dean completed ano signed. A completed certificate of death accompanies this Appropriate application. Box b. ,� Christina was contacted on 1/12/09 He/she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Venazio will complete and sign the medical certification of cause of death within 72 hours. C. was contacted on He/she verified that Medical Examiner, will complete and sign the medical oe ' cation of of death within 72 hours. 6. Funeral Director/ F.E. No./Reg. No. pate S ned rt.� --� -�• ,;Oa 44048 1/12/6 � B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -09 -0019 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. PA*atjd. V. •e Date 1 /11 /09 Date Certificate 16/09 Subregistrar Signature Q,�,y,Q„ " � OAMgL Issued: Due: 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 STORAGE Date of Disposition / p OCREMATION OTHER (Specify) Signature of Sexton or Person -in- Charge 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. Distribution: White: Cemetery or Crematory DH 326, 8197 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number: 5740.01x).0326 -2) Pink: Local Registrar FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY ima SEA HOME OF PELICAN ISLAND 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: S 7UNK FUNERAL HOUa No. GentrRI Ave. ADDRESS: SEBASTIAN. FL 32968 PHONE #: Chi SM1000 (Check One) XX OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME: Lot 32 Block 14 Unit 4 Lot Block Unit Niche Block Unit N S E W Jan. 15, 2009 10 A.M. FOR DECEASED: Eleanore C. Thompson Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) 4721 46f Name Signature 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. NAME AND SIGNATURE OF LICENSED FUNERI4L DIRE&OR: Name 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: Cdm qrfjry S, xion Date This form to be. provided to Clerk's Office by Sexton for permanent record upon completion. Name Z2 -t AL Unit Y Block % I/ J ,W7 /l 5 _) // /U Lot Date of Mark -out Date of Burial � Time Name of Funeral Home Authorized by i �M 2. S sS i i • 8 S O OU O S p � tO1� (O� O O rn �y NT CA Pr O � --� I O � O � � O 0 Y A Cf Ca IR a IR m N 0 07/05/2007 02:30 5615892583 STRUNK FUNERAL HOME '?AGE 01 'r 3o2 � ,g �°� �� Grp � GL �� s S'f s �-�-� ,�'�� 2, AP&I e yW/S�1c�/cE� �G�E�+/OE�� -jots of 1101140 1 County 9 1 --KIN PIWA. Typ. r StanP CbrrAnhalglwd amstmaymk c to mo, w T LINDA C. GRANT Notary Public, State of Florida My comet, exp. Mar. 10, 2005 Comm. No. DD 006845 ti is Jk alr or IP -3 SERASTE HOME Of PELICAN 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 Name(s) Address i Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only pt is acknowledged in the sum of: o� Dollars ($ 14Zee. Oa ) on this /-, & day of , 20 0,7 for the purchase of the following described Cemetery Lot(s) and or Niche(s). Unit _, Block , Lot(s) ,j�,Z -Y- 7,3 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 Vase and Ring for Niches (cost) Interment Lie T TAIL v Signature of P r haser 4t� y of ZSbastian e Service fees are to be paid at time of need only I: \W W- DATA \Ms - Cemetery\RECEIPT.doc W O H Circle One WARREN A. GUTHENBERG LORRAINE GUTHENBERG 1127 BREEZY WAY /j SEBASTIAN, FL 32958 Z7 / A P / _ /I 678 63-515/67D D ` 63- 515/670 ATE 32 r I �%2 -DOLLARS r list National TREASURE COAST CLUB BANK AND TRUST COMPANY THE SUPERCOMMUNITY BANK' SEBASTIAN, FLORIDA 32968 JI i:06700S LS81: 43 200 240560 067 T Z W Se FLI y0F m M a fW/fW0 0 J UJ t= � v� IV a a Y L A L v .y Y C) S3 m c ❑ U O LLd 70E N G 0 o o m E ' Y tl to x -a _j _j LL to ? ° U d m E 0 E E a $ L to d L) E to C7 U J U r Z U U J 3 r U d' O ONi M O S � S S co co Go (D O N N l'�J 'V' f J st M ttDD C7 to (7 � l') co m (Op tp7 to C'•1 O N N O N N O tOC) tOCJ O O LO � pN pN o co per_ S O S per_ O S S S S tOD S S t'D tOD tD LOP � 'O 'O A d e v Q a° is C CL V W e a