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Off OF
SFORMU
HOME Of PELICAN ISLAND
Certificate No. 1991
(CITY' Off' SEBASTIAN
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
George B. Keyes 726 Dempsey Avenue, Sebastian, F1 32958
(name) (address)
in and for consideration of the sum of $1,350. 00 has purchased and is entitled to full
interment rights in the Sebastian Municipal Cemetery for the following plot:
Unit_ 3_ Block _Col_ Niche _11Ds_
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 November, 2004.
OF SEBA ,5TIAN, FLORIDA
City
Saj1§'A. Maio, CMC
/ City Clerk
O '
Name MRR,/ M Cr?QjRIA)y ) 512
Unit 3
Cc Block C
Lot f f S
Date of Mark -out ' % - 3
Date of Burial Time /
Name of Funeral Homy F
Authorized by
Name
Unit_
Block
Lot _
-A�- // 2) A -
Date of Mark -out
Date of Burial Time l ��
Name of Funeral Home
Authorized by , !�fr(�l 19
GEORGE B. KEYES
George B. Keyes, 97, of Sebastian, Florida, died Friday, May 17 at
Nursing Care by Angels Assisted Living in Palm Bay, FL.
He was born October 22, 1915 in Worchester, Massachusetts In 1932
he formed the first unit of Barrington Sea Scouts in Rhode Island. He
attended the Rhode Island School of Design in Providence and
graduated from Mechanic's Institute, Rochester, NY in 1939.
George joined the Coast Guard as Chief Boatswain's Mate and CO of
the Coast Guard Reserve Schooner Mohawk (CGR -2543) in the Coastal
Picket Patrol based at Nantucket, Mass during 1942 -1943. He later
served aboard the Coast Guard manned transport USS Cavalier (APA-
37) where he was wounded during the landings at Linuyen Gulf on Jan.
8, 1945 during the Liberation of the Philippines.
He was employed by ANSCO Co. a division of GAF Corp. He retired as
a photographic engineer in 1973.
George was a member of the Photographic Society of America, Owego
Camera Club, US Power Squadron, Barrington Preservation Society,
Sterling Historical Society, Sebastian Area Historical Society, Friends of
the North Indian River County Library and Disabled American
Veterans.
He moved to Sebastian in 1979 where he helped establish the North
Indian River County Library. He was a volunteer at the library for 30
years. In 1985 he helped form the Sebastian Area Historical Society
and was a member of the board of directors. He worked with a
research group collecting historical records and stories of the early
settlers which were published in three volumes of Tales of Sebastian
books.
He is survived by 2 daughters, Carol Annis of Virginia and Judith
Knapp of California and 1 son, John Keyes of Florida; 2 grandchildren
Michael Annis and Nicole Annis Keeney, 3 great grandchildren,
Cameron Annis, Nathan Annis and Erin Keeney. He was predeceased
by his wife Peggy.
FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN
FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY
$E�K BAST
�N
IIOMF 6i Pflic" ISUNO
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:
ADDRESS:
PHONE #:
(Check One)
OPEN BURIAL LOT Lot Block Unit
OPEN CREMAINS LOT Lot _Block Unit
_1J/ PEN COLUMBARIUM NICHE Niche l0 Block Unit
W
BURIAL DATE AND SERVICE TIME ,�" (o `/e— S;, ),f
FOR DECEASED:
IVafTle
NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE:
(Must provide proper documentatioli of ownership)
Name Signature Date
I 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.
4-(A _
Name Signature
Date
Cemetery Sexton Certification:
I certify that I have checked the ownership infonriatlon by viewing the owner's deed and confirming
with Clerk's office and that all ees have been paid
AF
Ceme ry Sex n Dat
This form to be provided to Clerk's Office by Sexton for permanent record upon completion.
CHY OF
SEBASTKN 71
HOME OF PELICAN BLAND
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
G 2 49 -VV Cl ,0 T
Name(s) v
Address
5 ej ca dt -)'t
Area Code & Phone Number
7 7�L 5-,f T --/
Residence Address of Intended Occupant if Other Than Purchaser
Office Use Only
Receipt is acknowledged in the sum of:
Dollars
on this day of , 20e - for the purchase of the following
described Cemetery Lot(s) d /ox Niche(s).
Unit_, Block(_, Lot(s) Niche(s) l.�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 �/ S� D d W O H
Circle One
Vase and Ring for Niches (cost) Interment a?�^� d Disinterment
Signature o urchaser Cit .of ebastian
Service fees are to be paid at time of need only
I: \W W- DATA \Ms- Cemetery\RECE I PT.doc
1225 Main Street, Sebastian, F132958
Telephone (772) 589 -5330 — Fax (772) 589 -5570
November 1, 2004
Mr. George Keyes
726 Dempsey Avenue
Sebastian, Fl 32958
Dear Mr. Keyes:
Enclosed is City of Sebastian Certificate 1991 for the purchase of Cemetery Niche 11Ds, Block
COL, Unit 3. 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.
Sinc ely,
r-
Sally laic , CMC
City Clerk
SAM:ar
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001001208001
001501322900
001501341920
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CITY OF SEBASTIAN
CITY CLERK'S OFFICE
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001001208001
001501322900
001501341920
001501341910
001501341930
601010 343800
001501 343805
CITY OF SEBASTIAN
CITY CLERK'S OFFICE
RECEI 314 9
PT
❑ Cash
ock #
Amount Palo
Sales Tax
Garage Sales
CophWBki Specs.
LDCICode of Ordinances
Election Qualifying Fees
Cemetery Lots
LoUNkhe ljo(?S Blod "�_ Unit
C tery Fees
0.2- , 4? 0
c - .o c)
jr
ate r Total Pal// R O d
Initi
White — Dept. of Origin • Yellow — Finance • Pink - Applicant
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