HomeMy WebLinkAbout4-15-20o;
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HOME OF PELICAN ISLAND
Certificate No. 2026
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
William D. Gressinger, Jr. and/or
Tannie L. Gressinger 745 E. Fischer Circle, Sebastian, FI 32958
(tee) (address)
in and for consideration of the sum of 7~,OO.OU has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit 4 Block _15_ Lots 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 1st day of July, 2005.
CITY, OF SF~ASTIAN, FLORIDA A~
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Minner
Manager
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A. 'o, MMC
Crtv Clerk
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1225 Main Street, Sebastian, F132958
Telephone (772) 589-5330 -Fax (772) 589-5570
July 6, 2005
Mr. & Mrs. William D. Gressinger, Jr.
745 E. Fischer Circle
Sebastian, Fl 32958
Dear Mr. & Mrs. Gressinger:
Enclosed is City of Sebastian Certificate 2026 for the purchase of Cemetery Lot 20, Block 15,
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.
Sin y,
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Sally A. o, MMC
City Clerk
SAM:ar
enclosure
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HOME OF PEUGN ISI~-ND
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
~~`-~~/`'Y /~
Name(s) ~ v '
Address
Ar a Code & Phone Number
Residence Address of Intended Occupant if Other Than Purchaser
.Office Use Only
Receipt is acknowledged in the sum of:
_,~„~,~ /~ ~ ~ ~-~` Dollars ($7ao. oo )
yd
on this ,~,~ day of , 20crs' for the purchase of the following
described Cemetery Lots nd/ r Niche(s).
Unit ~, Block ~v ' ,Lot(s) r,2D 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 ~~~3^dd O H
Circle One
Vase and Ring for Niches (cost) Interment
Signature of Purchaser
City of Sebastian
Disinterment
TOTAL $ 770 0
~~~
Service fees are to be paid at time of need only
I :\W W-DATA\Ms-Cemetery\RECEI PT.doc
ILLIAM D. GRESSINGER JR. OR ~ 97
TANNIE L. GRESSINGER
745E FISCHER CIRCLE
SEBASTIAN, FL 32958 _ ~ ,~ 83-807/670
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B•ah.
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JU1V 1 KUST Money Marke
SunTrust Bank Account
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FLORIDA DEPARTMENT OF
HEALT
A. (TYPE)
c.
1. Name of First Middle Last Date Month Day Year
Deceased of
Vernon Dennis McCo Death July 1 2005
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 Addres~75 18th Street, X102 Phone Number
certifier Alec Y. Lui, .D. Vero Beach, FL 772-562-6818
Medical Examiner Physician
4. Name of Funeral Home/l~iFesl:Bie}~eaal Address Fla. Lic. No./Reg. 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.
was contacted on
He/she verified that
,Medical Examiner, will complete and sign the
medical I tion of death within 72 hours.
6. Funeral Girector/ ign Ore- F o./Reg. No. Date Signed
n~.e,.. ~I~....~~r 1862 7/1 /05
B.
BURIAL -TRANSIT PERMIT
Permission is hereby granted to dispose of this body. Permit No. 1228-05-0286
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.
~,~ Date Date Certifcate
SubregistrarSignature ~~. Issued: 7/1/05 Dye: 7/5/05
c.
Approval Number:
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
Stefanie was contacted on 7/5/05
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that Dr. LUI will complete and sign the medical
certification of cause of death within 72 hours.
State of Florida, Department of Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
AUTHORIZATION for CREMATION, DISSECTION, or BURIAL-AT-SEA
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. Awaiting period of 48 hours after death is
required for all cremations.
p. CEMETERY OR CREMATORY
Method of Disposition: Place of Disposition Sebastian Cemetery
BURIALSTORAGE Date of Disposition ~~~/~'j~.
CREMATION
Signature of Sexton 1
or Person-in-Charge J}
OTHER (Specify)
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 m .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 ~d ~Q~ ryye