HomeMy WebLinkAbout4-10-37Name �+J�
Unit '�•
Block
Lot
Date of Mark -out
Date of Burial 1646 /1S Time %( ' oD/4•
Name of Funeral Home
Authorized
RAY JAMES (DONNIE) HESTER
Ray James (Donnie) Hester, 81, of Palm Bay, died at 10:00 pm, Saturday, October 3, 2015 at Palm Bay
Hospital in Palm Bay, FL. He was born February 22, 1934 in Detroit, MI. He is preceded in death by his
parents, Herbert (Frank) and Ella (Robinson) Hester, his three brothers, Bruce, Robin, and Dale, and his
loving wife Joyce.
He was married to Joyce Ann Ash November 3, 1956, which was the love of his life as they've known
each other since 3 years old. They were married for 54 years before her death in March 2010. Ray is
survived by his children; Mary, Gregg (Jamie), Judy (Kirk), Patrick, Kelly (Rick), Christopher, Katie, Mike,
and many grandchildren and great-grandchildren.
Ray was a long time resident of Vicksburg, MI before moving to Palm Bay, FL in November 2007. He
retired from General Motors of Kalamazoo, MI in 1993. Ray loved to work on cars, watch football, play
golf, go for walks, eat out, enjoy the ocean, and relax on his porch. He was a loving husband and father
and will be greatly missed.
CITY OF
HOME OF PELICAN ISLAND
Certificate No. 2251
ITY OF�'B ,STI 1
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Ray J. Hester 1743 Red Bud Circle, NW, Palm Bay, Fl. 32907
(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 lot:
Unit 4, Block 10, Lot 37
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 15th day of April, 2010.
CITY OF SEBASTIAN, FLORIDA
' �) Al Minner
City Manager
ATTEST:
Sally,K. Maio, MMC
City Clerk
Name �, �� •
Unit
Block
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Lot
37
Date of Mark -out
Date of Burial
7/%c / �O Time / / • � � ,,�%'F✓ll /
Name of Funeral Home
Authorized by_,
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Oct 13 1503:26p
l0/L2115
02:10tt HP LASERJET FAX
FUNERAL OiRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
S�
.aw w nix.,,wa
For Informalior contact:
Kfp:Kelso • Cmnetery Sexton
Sebosrien AA mWpel Cemetery
(772)589.25-05
: City Clerk's ORfce
City Hall, 1225 Alain Street
Sebastian. FL 32958
Oflko (72?) 39e-9215 or 389.82 id
Fax. (772) 589.5570
FUNERAL HOME:
p.02
p.1
(Check One)
.APEN BURIAL LOT Lot Block Unit
-DPENCREMAiNSLOT Lot., 3�„„81ock-p Unit VJ!}-Vl ,�qCL'
,.OPEN COLUMF4ARIUM NICHE Niche Block Unit �eS+f tt�
W
BURIAL DATE AND SERVICE TIME 1 r C-
Qui` SR L I I I d21
FOR DECEASED. 2OLV ameS I {P r
iveme rrr'
NAW AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentation of ownership)
NameSignature Date
I Certify that I nave determined the ownership of the above described 4ite that ell site foes and
administrative fees hake been paid and authorize opening of same
NAME AND SIGNATURE OF LICENSE D FUNERAL DIRECTOR.
Narne b�gnature Dals
......rtlfi.-i---ca---uo:-n----------------------
_......................
*--------
-------
_......._............
.
Cemetery Sexton Ce
I certify that I have chocked the ownership :nfonnabon by viewing the owner's deed and confirming
with Clerk's office and that all fees nave been pato
4- GET
e exon Date
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
A
Replacement permit
FLORIDA DEPARTMENT OF for deceased coming
HEALT State of Florida, Department of Health, Vital Statistics out of storage and
APPLICATION FOR BURIAL - TRANSIT PERMIT being buried.
A. (TYPE)
1. Name of First Middle Last Date Month Day Year
Deceasedof
Joyce Ann Hester Death March 13, 2010
2. Place of Death
Coun
revard
City, Town or Location
Melbourne
Name of (If neither, give street address)
Hosp. or
Inst. Holmes Regional Medical Center
3. Name of'Mi E1maghraby, MD Aadress1314 Oak Street
Certifier Melbourne FL 32901
Medical Examiner Physician
4. Name of Funeral Home/Direct DisposV6691 Add Tdbi
South Hickory Street
S`Ot"shff �/ard Funeral Home 1MUeUlbourne FL 32901
Phone Number
(321) 727-7992
Fla. Lic. No./Reg. No. Phone No. (Area Code)
F041850 (321) 724-2222
5. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this
Appropriate application.
Box
b. was contacted on
He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,
and that 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
edical certification o use of death within 72 hours.
6. Funeral Director/ i ure F.E. No./Reg. o. Date Signed
Direct Disposer FO 04/11/10
B. BURIAL - TRANSIT PERMIT
Permission is hereby granted to dispose of is body. Permit No. F041850-10410
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 cert ftc/ to has been requested.
4
Registrar or r `. /l Date Date Certificate
Subregistrar Signature �` `�V �^- Issued: 04/11/10 Dye: 03/23/2010
C. AUTHORIZATION for CREMATION, DISSECTION, or BURIAL -AT -SEA
Approval Number: Date
7
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.
Method of Disposition:
BURIAL
La
❑CREMATION
Signature of Sexton
or Person -in -Charge
FISTORAGE
❑OTHER (Specify)
CEMETERY OR CREMATORY Sebastian Cit Cemetery
Place of Disposition y y
Date of Disposition -7//Iho -
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.
DH 326, 8/97 Obsoletes all previous editions Distribution: White: Cemetery or Crematory
( P ) Yellow: Funeral Director or Direct Disposer
(Stock Number: 5740-000-0326-2) Pink: Local Registrar
xKxi�e Z r.nQ
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
SEWISTM
Noml Oi P"" WND
For information contact:
Kip Kelso - Cemetery Sexton
Sebastian Municipal Cemetery
(772) 589-2545
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: `'�,t,,� „(41
ADDRESS:
PHONE #:
(Chea One)
PEN BURIAL LOT Lot 3 T Block /ti Unit
OPEN CREMAINS LOT Lot Block Unit
-(JPEN COLUMBARIUM NICHE Niche Block Unit
W
BURIAL DATE AND SERVICE TIME:
FOR DECEASED:
ivame
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must r vide prode-Ndotumentation of ownership)
Name Signature Dafe
certify that I have determined the ownership of1he 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.
Name Signature Date
------------------------------------------------------------------------------------------------------------------------------
Cemetery Sexton Certification:
I certify that I have checked the ownership inforn-iation by viewing the owner's deed and confirming
with Clerk's office and that all fees have been paid
Cemittery,66fon Date
This for►T1 to be provided to Clerk's Office by Sexton for permanent record upon completion.
Cit.Y of Sebastian
schaNhiii ('rrnejcry
Ph. N h772) SMO Z545
Fax 4 Q777)22M Qq27
Now isk is for Infurnntfi(inAl purposes reguiriling Monument~ At Sebastian ('emeturN
NOU, 7 This is fora 1)(mbit: Marker under 2 fl. & fp%cr 2 lt. (neer 1 D, is , POumd Gundation )
I'leaw return to (its Of wh4+11all
Sebastian ('rIM"Vp
1921 Nui-th (111WA Aw,
32158
Attention ("Met"; S"Um
Nor lose
Die -
'N 2111ts D;1 les
Hers Joyce R. Hester
D.O.W
.................
1932
WALK
A.L7. 2010
4
tnt
Block 10
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Lim 8/13/10
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shale& stone granite co.
date: 8/13/10
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