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HomeMy WebLinkAbout4-14-26Certificate # 1896 aIr or SEXAST_" HOME OF PELICAN IWM ((I (1 10 <4 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Marie J. Faraoni (name) (name) 199 S. Wimbrow Drive, 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) 25 & 26 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 25thday of April 2003 CI OF SEB TIAN, FLORIDA Terrence R. re City Manager ATTEST: rfi Sally A.*1o, CMC City Clerk 0 0 Name +i�.t /,f 1., .2 _f G'A'C', f,/ / //j( 1. 3 '�,tz5. Unit Block _L Lot ?< L_; Date of Mark -out , Date of Burial / Time — ~� Name of Funeral Homo Authorized by _C1TYOF -SERA -- CITY CLERK'S OFFICE 4 RECEIPT Name Sa"Cash Date — �Check No. Amount Paid 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDC/Code of Ordinances 001501341930 Election Oualif" Fees t 601010 343800 Cemetery Lots Lot/Niche -- Bkx* Unit 001501343805 Cemetery Fees —"_�— Total Palo 5� kc White — Dept. of Origin • Yellow — Finance • Pink • Applicant �l5o,oa Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper Death Notices I Onli... Page 1 of 1 MARY JOSEPHINE "MARIE" FARAONI Mary "Marie" Josephine Faraoni, 92, died Sept. 4, 2009, at her home. She was born in Cozenia, Italy, and lived in Sebastian for 20 years, coming from Rensselaer, N.Y. She was a homemaker and former member of St. Anthony Society in Rensselaer. Survivors include her daughters, Pauline O'Leary of Albany, N.Y., Marie Landon of Palm Bay and Anita Herbst of Sebastian; six grandchildren; and seven great - grandchildren. She was preceded in death by her husband of 67 years, Anthony A. Faraoni; and son, Anthony A. Faraoni Jr. Memorial contributions may be made to St. Sebastian Catholic Church Building Fund, 13075 U.S. 1, Sebastian, FL 32958. Services: Visitation will be from 10 to 11:30 a.m. Sept. 8 at Seawinds Funeral Home Chapel in Sebastian. A funeral Mass will be celebrated at noon Sept. 8 at St. Sebastian Catholic Church. Burial will follow in Sebastian Cemetery. A guest book may be signed at seawindsfh.com /obit.php. Published in the TC Palm on 9/6/2009 T.od;ry.'s._T....C__Pal m_ _obituaries Questions about obituaries or Guest Books? Con #act Legacy.com • Terms _of_use Powered by Legacycoin obituaries nationwide Back http:// www .legacy.com/tcpalm/Obituaries. asp? Page= LifeStoryPrint &PersonlD= 132349571 9/9/2009 FLORIDA DEPARTMENT OF HEALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1/_N_C�� 1. Name of First Middle Last Date Month Day Year Deceased of MARIE FARAONI 09 04 2009 Death 2. Place of Death City, Town or Location Name of (If neither, give street address) County INDIAN RIVER SEBASTIAN 177 EMPRESS AVE InHosstp. 3. Name of Medical Address Phone Number Certifier RALPH B. GEIGER, MD 13838 US HWY 1 Medical Examiner I X lPhysician SEBASTIAN, FL 32958 772- 581 -6900 4. Name of Funeral Home /Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment 735 S FLEMING ST SEAWINDS FUNERAL HOME SEBASTIAN, FL 32958 2617 772 - 589 -1933 5. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. 0 DR. GEIGER was contacted on 09/04/09 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that HE 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 certification us of death within Vhours. 6. Funeral Dire Signature F.E. No. /Reg. No. Date Signed Direct Disp er FO 42919 09/04/09 B. BU IAL -TRANSIT PERMIT Permission is hereby giant to dispose of this body. Permit No. 09- 2617 -197 © A five (5) day extei of time for filing the death ce to (exclusive of weekends) has been requested and granted since the physician has been contacted by the funeral director and will of be able to complete the medical certification of cause -of -death section of the death certificate within 72 hours. F] No extension of time for fili g th death ce ifi to hah bee requested. Registrar or ± Date Date Certificate Subregistrar Signature Issued: 09/04/09 DUe: 09/16/09 C. ATH6RIZATION 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 FISTORAGE Date of Disposition FICREMATION 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 Rscrrlcd � Yapn 0910412009 14:46 7725895570 CITY OF SEBASTIAN Sep 04 09 02'30p SEAWINDS FN 17725891939 Sep 04 2009 23LOP" cos cEmErERY 7722299927 DIREC or rF.EiA$TIAN .TOR,s REQUEST TO CITY Ry FUNERAL jH() IN SEBASTIAN MUNICIPAL CEMETERY tnu MARIAL OPEN jop X#)So. Cgj"gtwy $0400 sjjb&sfj*ft Me"of to,"AiVy (772) 00-2$45 afy cw* *8 oft# City #OOL 1225 lwpfn s&*st S*us$j)*n, FL 32950 oft. (?M 30g.8215 or,768411214 'Cow, (777) Sao-5370 '6 eA FUNERAL 40ME; L-3 - r I A.D61Ress —7 ,. 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