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P 'Al Minner
City Manager
QTY OF
HOME OF PELICAN ISLAND
Certificate No. 2138
CITY OF SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Mary C. Charles E. O'Clair 951 Laurel Circle, Barefoot Bay, Fl 32976
(name) (address)
In and for consideration of the sum of $2,700.00 is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following
Lot(s) /Niche(s)
Unit 3 Block COLLot(s) /Niche1 2 Sn
of the Sebastian Municipal Cemetery,
as maintained on file in the records of the City Clerk
for use in accordance with the conditions, ordinances, resolutions, rules and
regulations prescribed therefore by the City of Sebastian.
CONVEYED THIS 2nd day of July, 2007.
ASTIAN, FLORIDA
ATTEST:
Jeanette Williams, CMC
Deputy City Clerk
Name /1'$// Q //8 C CU /Q/�'�M��I✓,S
y
Unit 3
Block CO 1
Lot
NI4t- /N.
Date of Mark -out
Date of Burial 24.7./1 a
Name of Funeral H e si:o 1
Authorized by
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEIPT
Name al Cash
Date 3-1 0 `0 Check
111��� Amount Paid
No.
001001 208001 Sales Tax
001501 322900 Garage Sales
001501 341920 Copies/Bid Specs.
001501 341910 LDC /Code of Ordinances
001501 341930 Election Qualifying Fees
601010 343800 Cemetery Lots
Lot/Niche c3''! Block
001501 343805 Cemetery Fees
Time
Unit 3
Total PaidV
itials
White Dept. of Origin Yellow Finance Pink Applicant
(?,t3i�E D6
In Memory of
Mary Caroline O'Clair
April 29, 1914 December 19, 2009
Mary Caroline O'Clair, 95 of Barefoot Bay, FL passed away Saturday, December
19, 2009 at Palm Bay Community Hospital in Palm Bay, FL.
She was born April 29, 1914 in Winthrop, MA and was a resident of Barefoot Bay
since 1985, coming from Littleton, MA.
Mrs. O'Clair was the owner of Littleton Hallmark Gift Shop and was a member of
St. Luke's Catholic Church and sang in the Choir, she enjoyed playing organ and
was a square dancer.
Survivors include her two sons Charles E. O'Clair, Jr. of Friday Harbor, WA,
Stephen J. O'Clair of Aptos, CA; daughter Mary Patricia Hutchins of Anacortes,
WA; five grandchildren and five great grandchildren.
A memorial service will be held at a later date.
r
1
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
:ma
SEES fAN
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: E 44 A.S
ADDRESS:
PHONE c 3
(Check One)
1
OPEN BURIAL LOT Lot
OPEN CREMAINS LOT Lot
OPEN COLUMBARIUM NICHE Niche
BURIAL DATE AND SERVICE TIME:
HOME OF PELICAN ISLAND
For information contact:
Kip Kelso Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589 -2545
s r 5, t J
Block eed. Unit 3
Block Unit
Block Unit
N S E W
FOR DECEASED: IA R. c..t 0 C (P t
Name t
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
Ct A-e t &.s r cl+t-gR.
Name
Signature
12 -24 -os
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 FUNERAL DIRECTOR:
CAL
Name (Signature
mod, 6 65
Date
Cemetery Sexton Certification:
1 certify that I have checked the ownership information by viewing the owner's deed and confirming
with Clerk's office and ha all fees have been paid:
Cemetery n t 1 7/ t9
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
Vero Beach Crematory, LLC
1830 Wilbur Avenue
Vero Beach, Florida 32960
Certificate of Cremation
We hereby certify that these are the cremated human remains of:
Mary Caroline O'Clair
December 19th, 2009
(date of Death)
Seawinds Funeral
Home and Crematory
(Funeral Home in charge)
01709
(Cremation ID Number)
December 29th, 2009
(Date of Cremation)
Sebastian, Florida
(City and State)
7
(Cremator Signature)