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HomeMy WebLinkAbout4-11-01Name Unit Block Lot Date of Mark -out Z Date of Burial 9�/ Time `' re 4 /� Name of Funeral Home Authorized by FRANK JOHN DEJOIA June 26, 1924 - June 4, 2017 Mr. Frank John DeJoia, 92, died June 4, 2017 at Consulate Health Care in Vero Beach, FL. He was born in Brooklyn, New York and has lived in Roseland, Florida since 1980. Frank obtained his BS from Tufts University in Civil Engineering and in 1945 obtained his MA from Columbia University in Geology. He was a veteran of the U.S. Navy having served on the USS Mississippi AG 128, and was the recipient of the American Theatre Medal and WWII Victory Medal. Frank worked as a Geologist for Creole Petroleum a subsidiary of Exxon for 23 years in Venezuela. After his retirement he moved back to Florida where he worked as a Real Estate Broker in Boca Raton, Florida and Sebastian, Florida. He was a member of St. Sebastian Catholic Church, Sebastian, Florida; a founding Board member of the Friends of the St. Sebastian River, a member of the Roseland Property Association Board and past member of the American Association of Petroleum Geologists. Survivors include daughters, Mary Ramsay (Bert) of Virginia Beach, Virginia and Diana DeJoia of Sebastian, Florida; sons, Stephen DeJoia (Sherry) of Sebastian, Florida and Thomas DeJoia of Boca Raton, Florida; Seven grandchildren and six great grandchildren. He was preceded in death by his wife of 52 years, Joyce DeJoia. Memorial contributions may be made to Friends of St. Sebastian River, P.O. Box 282, Roseland, FL 32957 in memory of Frank DeJoia. Visitation will be held at 10:00 - 11:00 AM on Friday, June 9, 2017 at Strunk Funeral Home Chapel, Sebastian, Florida followed by a Prayer Service at 11:00 AM in the chapel with Deacon John Dunlop, celebrant. Following the service interment will take place at Sebastian Cemetery, Sebastian, Florida. Bom: June 26, 1924 Death: June 4, 2017 CITY OF SEBASTIAN 10721 ADMINISTRATIVE SERVICES RECEIPT Name!34RU,,S< /b6fC/A ❑Cash Date ,71t7 Check# -7& 4 O Credit Amount Paid 001001 208001 Sales Tax 001001 220000 Security Deposit 001501 362100 Taxable Rent 001501 362150 Non -Taxable Rent 450010 369900 Airport Badge 001001218010 CobraServe 001501 354100 Code Enforcement Fines 001501 347557 Community Center Revenue 001501341920 Copies 001501 351140 Parking Citation 001501 342100 Police Security Services 001501 329200 Site Plan Review 001501 329300 Subdivision/Plat Review 001501 329100 Zoning Fees nots-ni 343800 OAC. Unf,T* Btkil LOT ! Total P A-1- fifials Security Dep Held - Amount $ Check # White - Dept. of Origin • Yellow - Admin. Svcs. • Pink - Applicant FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Kip Kelso, Cemetery Sexton n A r Sebastian Municipal Cemetery C' Phone: (772) 589-2545 \ Fax: (772) 228-9927 U City -Clerk's Office – Cathy Testa City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388-8215 or 388-8214 ctesta(u)cityofsebastian.org FUNERAL HOME: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE#: 772-589-1000 (Check One) XXXX OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME Lot 1 Block 11 Unit 4 Lot—Block—Unit Niche Block Unit N S E W Friday, June 9, 2017, 11:00 AM Chapel Service at Strunk Funeral Home FOR DECEASED: Frank John DeJoia Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Mary Ramsay Mar� RRMSCI� 6/6/2017 Name Signature Date 3933 Regal Court, Virginia Beach, Virginia, 23452 1 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: Tim Marvin Name Tim McuuiK 6/6/2017 Signature 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: Cemetery Sexton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. 06/06/2017 14:59 FUNERALI FOR BURIAL Office (772) FUNERAL ADDRESS: PHONE* 1Check One) 2 X OPEN BURIAL LOT OPEN CREMAIN$ LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TI FOR DECEASED: Name NAME AND SIGNATURE OF LOT OW (Must provide proper documentation of Mary Ramsay Name 3933 Regal Court, Virginia Beach, Virginia, 23452 1 certify that I have determined the owners fees have been paid and authorize openir NAME AND SIGNATURE OF LICENSED Tim Marvin Name 'S REQUEST TO IN SEBASTIAN P For information con t Kelso,. Cemetery Phone: (772) 889-254 Fax: (772) 228-9927 .Clerk's Office -- Ca 'ity Nall, 1225 Main Sebastian, FL 32. 15 or 388-8214 cts Lot__1_BI June 9,2017, 11:00 OR REPRESENTA Signature tip of the above descht I of same. rUNERAL DIRECTOR: Tx Maw Signature OF 11 Chapel that all 18847 P.001/001 it (icp at Strunk Funeral Home fges and administrative Cemetery Sexton Certification. I certify that I have checked the ownership information by viewing th wner's dee no confirming with Clerk's office and that all fees have been paid: uemereryaxion Date This form to be provided to Clerk's Office b Sexton for permanent r ord upon State of Florida, Department of Health, Bureau of Vital Statistics ---- BURIAL TRANSIT PERMIT HEALTH DATE PRINTED: June 6, 2017 TRACKING NUMBER: 2017091655 1. DECEDENT INFORMATION Name of Deceased Date of Death FRANK JOHN DEJOIA June 4, 2017 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER VERO BEACH CONSULATE HEALTH CARE OF VERO BEACH Name and Address of Funeral HomelDirect Disposal Establishment Fla. Lic. NodReg. No. Phone Number STRUNK FUNERAL HOME -SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 Funeral Director/Direct Disposer Fla. Lic. No./Reg. No. TIMOTHY W. MARVIN F022789 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number 2017-5041870-5114 �— Date Issued: June 5, 2017 State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY Method of Disposition: BURIAL Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10/12 64V-1.011, Florida Administrative Code C(iY OF ~~ ~~~~~~ HOME OF PELICAN ISLAND Certificate No. 2186 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Mr. Frank DeJoia 11625 Roseland Rd, Sebastian, FL 32958 (name) (address) In and for consideration of the sum of $2,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following lots: Unit 4 Block 11 Lots 1 & 2 of the Sebastian Municipal Cemetery, as maintained on file in the records of the City Clerk for use in accordance with the conditions, ordinances, resolutions, rules and regulations prescribed therefore by the City of Sebastian. CONVEYED THIS 2nd day of July, 2008. CI OF BASTIAN, FLORIDA ATTEST: ~; i 1(/ ~ ~ / AI Minner _ Sall .Maio, MMC ity Manager City Clerk __ ~.~ [~ _.__ ~ ~~ HOME QF P ELIC,AP3 ISL1iN~ City of Sebastian Municipal Cemetery Purchase Receipt To enable the City of Sebastian to determine the correct rate, and in accordance with cemetery rate regulations, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. ((``~~~ X12 L~N~ ~~~ Name(s) Address I i j „ ~ ~~~ ' ~~~~/vl ~ ~-- ~~15 `7 Area Code & Phone Num Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: ~1~fl ~~Q~~ -Dollars ($ 0~-000 -°~ ) ~~11 N~ on this. o~ day of , 20~ for the purchase of the following described Cemetery Lot(s) and/or Nich ). Unit ~ ,Block ~, Lot(s) ~ ~i o2 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 O H ircle One Vase and Ring for Niches (cost) Interment Temporary Marker Preparation & Installation Disinterment TOTAL $c~.-~~ ~ Signature of Purchaser The following documents were provided as Proof of Residency: !:\wW-DATA\Ms-CemeterylREGEIPT.doc ' and City of Sebastian ©E~!26/2©08 ©3:24 5615892583 STR.UNK FUNERAL HOME PAGE D1 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY ~~ Mir a -[ucN+ aw+n For information contact Kip Kelso -Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City clerks Orllca City Hall, 1225 Main Street Sebasf/en, FL 32958 Ol/ice (772) 388-8215 or 388-6214 Fax: (772) 589-5570 FUNERAL HOME: Strunk Funeral Home ADDRESS: 1623 North Central, Avenue; Sebastian, FL PHONE #: 772-589-1000 (Chick One) ~/ OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL BATE AND SERVICE TIME Lot 2 Block 11 Unlt 4 Lot Block Unit Niche Block Unlt N S E W Jul 2 2008 11 A.M. FO'R DECEASED: Joyce DeJola Name -- NAME AND SIGNATURE OF I.OT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) ~~nK ~~ Soy' y ~ /~./oa Name ignature ~ Date certify that I have determined the ownership of the above described site, that all site fees and administrative tees have been paid and authorize opening of same. NAME AND SIGNATURE OF LICENSED FUNS L DIRECTOR: ~~ ~ nt o _ r L~~1jAf~ ~~~ ~ 3 O'B Name Signature ate ------------------------------------------------------------------------------------------------------------------------------ Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: 3o B$. Ceme ry xton Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. CITY OF SEBASTIAN CITY CLERK'S OFFICE 4 O 8 Q RECEIPT v UU t n ,, Name ~ ~d~- ~ ^ Cash DateT~ ~~C1 Check#~~~ No. Amount Paid 001001208001 Sales Tax 001501 322900 Garage Sales 001501341920 CopieslBid Specs. 001501 341910 LDC/Code of Ordinances 001501 341930 Electron Qualifying Fees 601010343800 Cemetery Lots ~ LoUNiche ~_, Block ~, Unit 001501 343805 Cemetery Fees ~~~ Total PaidD_--- als White -Dept. of Origin • Yellow -Finance • Pink -Applicant