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Home My WebLink About4-17-19aTyor S HOME OF PELICAN ISLAND Certificate No. 2014 GIT1 Y OF SEBAS -77IA Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Isaac D. Cathey (name) 9844 Riverview Drive, Micco, Fl 32976 (address) in and for consideration of the sum of $2,250.00 has purchased and is entitled to full interment rights in the Sebastian Municipal Cemetery for the following plot: Unit —4— Block 17 Lots 19 & 20 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 21st day of April, 2005. CITY OF SEBASTIAN, FLORIDA ATTEST: James A. Davis L/ " Interim City Manager 6 'A. Maio, MMC City Clerk Name Unit Block Lot Date of Mark -out Dt f6 it `/x�� aeo ura Name of Funeral Home Authorized by N X_ - , 3 ,,ov 5 . Time '/o0 FLORIDA DEPARTMENT OF HEALTState of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT topf A. (TYPE) 1. Name of First Middle Last Date Month Day Year Deceased of Isaac Dalton Cathey Death Jan. 23 2006 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 Nasir Rizwi, IPiffi . 13885 U.S. #1 Medical Examiner r Physician Sebastian, FL 772 - 589 -6844 4. Name of Funeral Home /Di posal Address 1623 N. Central Ave. Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment Sebastian, FL 1228 772 -589 -1000 Strunk Funeral Home 5. Check a. The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Linda was contacted on 1/24/06 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Rizwi will complete and sign the medical certification of cause of death within 72 hours. C. M was contacted on He /she verified that Medical Examiner, will complete and sign the medical 96qficatiorygWAXe rAdeath within 72 hours. 6. Funeral Director/ Si at F.E. No. /Reg. No. Date Signed DKect�'t� p'ose'r 2 1/23106 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-06 -0035 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. or Date Date Certificate Subregistrar Signature Issued: 1/23/06 Dye: 1/28/06 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 j (BURIAL FiSTORAGE Date of Disposition / io CREMATION 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, 8/97 (Obsoletes all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number 5740. 000 -0326 -2) Pink: Local Registrar R°F'd i1 r'O x! 14 Total Paid OQ Initials White — Dept. of Origin • Yellow — Finance • Pink . Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT Nam L► ❑ Cash Date No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC /Code of Ordinances 001501341930 Election Qualifying Fees � 601010 343800 Cemetery Lots I. Lot/Nichl, Block Uni 001501 343805 Cemetery Fees x! 14 Total Paid OQ Initials White — Dept. of Origin • Yellow — Finance • Pink . Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE 3508 RECEIPT Name ❑ Cash l Date ' ' heck $ �5 No. Amount Paid 001001 208001 Sales Tax 001501322900 Garage Sales 001501 341920 Copies/Bid Specs. 001501341910 LDCICode of Ordinances 001501341930 Election Qualifying Fees 601010 343800 Cemetery Lots Lot/Niche , Block , Unit 001501343805 Cemetery Fees 7�1 � 0 G r /� •r Total Paid In ials White - Dept. of ripin • Yellow - Finance • Pink • Applicant and or SEBASTKN 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 c;) ( . �t Name(s) f i8fg;;( .i'r.Gyi�t u� �!.�. �aF . i�cco,, F� .&ez 7a 'Address 77a - 66Y- 723i Area Code & Phone Number Residence Address of Intended Occupant if Other Than Purchaser Office Use Only Receipt is acknowledged in the sum of: on this .27ZA20"" day of described Cemetery Lot(s) d /or Niche(s). Dollars ($0?,5"d. OD ) 20 Dior the purchase of the following Unit , Block / �' , Lot(s) 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 - $20) Opening & Closing Vase and Ring for Niches (cost) Interment D� Signature of Purchaser W O H Circle One Disinterment e T TA j e e ity of Sebastian Service fees are to be paid at time of need only 1:1W W- DATA\Ms- CemeterylRECEI PT.doc MICCO I.D. Cathey I.D. "Joe" Cathey, 85, died Jan. 23, 2006, at Se-' bastian River Medical Center in Roseland. He was born in Hamilton, Texas, and lived in Micco for 1$years, coming from Miami. He owned and operated Cat - hey Contractors .Inc., in Mi- ami. He was a member of the Moose Lodge No. 1767, Sebas- tian, and the Little Hollywood Home Owners Association. He served in the Navy dur- ing World War II and retired from the Navy Reserves. Survivors include a son, Wayne Allen Cathey of Miami; and two grandsons. He was preceded in death by his wife, Grace F._Cathey;,.and a'son, Dalton Cathey. SERVICES: Visitation will be from noon to 1 p.m. Jan. 28 at j the Strunk Funeral Home, Se- bastian. A service will follow at 1 p.m. in the funeral home chapel, with the Rev. Gary Isn- er officiating. Burial will be in Sebastian Cemetery, with full military honors conducted by the American Legion Post 189, Veterans of Foreign Wars Post 10210 and Polish Legion of American Veterans Post 210,:.11 all of Sebastian. �dv&.k.w,� Sr {o` 6+ C3 t 1C 1 7 ,._4--r 19 - o-►.,k `�e -cam. -, COPY April 21, 2005 Mr. Isaac D. Cathey 9844 Riverview Drive Micco, Fl 32976 Dear Mr. Cathey: MY OF SUBAST A k1 HOME Of PELICAN ISLAND 1225 Main Street, Sebastian, F132958 Telephone (772) 589 -5330 — Fax (772) 589 -5570 Enclosed is City of Sebastian Certificate 2014 for the purchase of Cemetery Lots 19 & 20, Block 17, 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