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Home My WebLink About2-50-05GiY OF �� '��I�� ..�. .. H�ME C7�F P�LI�AN ISLANQ Certificate No. 2238 �� Certificate of interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Janice Pestrichelli Post Office Box 780815, Sebastian, FL 32978 (name) (address) In and for consideration of the sum of $4,000.00 is entitled to full interment rights in the Sebastian Municipal Cemetery for the following Iots: Unit 2A, Blk 50, Lots 5& 6 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 8th day of October, 2009. OF �BASTIAN, FLORIDA � -� AI Minner City Manager ATTEST: , � i � .--- Sally . Maio, MMC City Clerk Name ��.�� /V�—.l��.S/KiC��.�L.��,�� f�� Unit � ~,[Z Block Lot Date of Mark-out �/ � 6 e�� ' Date of Burial � / /?/ Time /� �°°� ' E /� ,�,L. Name of Funeral Home �� u�''� �� ,/�� . . � . � n . Authorized by 7 C .i'� c N i S m 1 O �.. � � 0 m • � m f � m _ . � � r ,� O s � � � C9 d 7 d �(� Gl G O 0 0 � A W O U rn o 0 0 z v z 0 0 o g o o d y o io, v, cn in o m 3 0 0 0 0 0 o en W W (,� W W N �� A j A A N O � CJ N OD 00 (D (D CD (O O O O O O O � � � � � � v � � � t� cj � O Ci y T � r c � �i y " � � � � � � �' O u' �'o n . � � � � � � � "_ 1 ' c � � a O l "% �. , i�• � ❑ C) n � d n y x � � a 0 � a � a �A n � mmo m�m � N W � � N T � "s mZ � � O� U BART J. PESTRICHELLI September 15, 1926 - April 11, 2012 Mr. Bart J. Pestrichelli, 85, died April 11, 2012 at Sebastian River Medical Center, Sebastian. He was born in Los Angeles, California and lived in Sebastian for 33 years coming from Teaneck, New Jersey. He served in the US Navy during World War II. He was Owner of the Wigwam Tavern in Teaneck, NJ for 15 years. Upon relocating to Florida he was a partner to the World Gym and New Life Rehab facility located in Vero Beach, FL. Survivors include his wife of 33 years, Janice A. Pestrichelli of Sebastian; sons, Rick Pestrichelli and his wife, Jennifer of Montgomery, AL, Rick Sarcinello and his wife, Robin of Vero Beach; daughter, Kathy Pestrichelli of Upper Saddle River, NJ; brother, John Pestrichelli and his wife, Anelle of River Edge, NJ; nephews, Jimmy Pestrichelli and his wife, Mary Ellen of Bridgewater, NJ, Jay Pestrichelli and his wife, Lynn of Omaha, NE; grandchildren, Kristen and Connor Pestrichelli, Kyle Pestrichelli, Nick Sarcinello, Zack and Cameron Budde, Ashley Farruggio; brother-in-law, Michael Cook and his wife, Val of Fair Lawn, NJ; nephews, Sean and Todd Cook. He was preceded in death by his daughter, Lizbeth Sarcinello Budde; sister, Ann Pestrichelli. , � FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING 1N SEBASTIAN MUNIClPAL CEMETERY UIYR HOME OF PELICAN 151ATD For information contact: Kip Kelso - Cemetery Se�rton Sebastian Municipal Cemetery (772) 589-2545 FUNERAL HOME: ADDRESS: PHONE #: City Clerk's Office City Hall, 1225 Main Strest Sebastran, FL 32958 Office (772} 388-8215 or 388-8214 Fax: (772) 589-5570 STRUNK �UNERAL HOME & CREM�4�'URY 1623 No. Centrat Ave. /�(Ch k One� OPEN BURIAL LOT Lot � Block �O Unit � OPEN CREMAINS LOT Lot Biock Unit OPEN COLUMBARIUM NlCHE Niche BI ck Unit � BURIAL DATE AND SERVICE TIME: I V�� ----'� ►,' - I FOR DECEASED:��Y �� e-Si r I C�1 e I�( Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide pro er documentation of ownership) � �C,�.r� 1 C� ��Y1G�ne�l l� �JG�.LC.�..�.� C��( �" I�-�I 2— Name Signature Date I certify that I have deterrnined the ownership of the above described site, that all site fees and administrative fees have been paid and authorize opening of same. AND SI TURE OF LICENSED FU RAL DIREC�OR: � l�.✓�Y� O�;�YI��I�..� 13-. �I 2- Name Signature Date Cemetery Sexton Certification: I certify that E have checked the ownership information by viewing the owner's deed and confirming with Clerk's o�ce and that all fees have been paid: o . � ,� Y,6 �z . Cem �ery exton Date This form to be provided to Clerk's Office by Sexton for permanent record upon cornpletion. f� F^°"DEP'�T"'ENTOF State of Floric�a, Department ofi Health, Vital Sta�t6stics ��1 APPLICATION FOR BURIAL - TRA►NSIT PERMIT A. (TYPE) 1. Name of First Middle Last Date Month Day Year Deceased gartholomew Joseph Pestrichelli °f April 11, 2012 Death 2. Piace of Death City, Town or Location Name of (If neither, give street address) County Indian River Sebastian Hosp. or Sebastian River Medical Center Inst. 3. Name af Medical i Address Phone Number Certifier Linda R. 0' Neil 2500 South 35th Street i772) 464-7378 �jMedic:al Examiner Physician F orida 34981 4. Naine of F�meraf Fiome/Qirect Gisposal Address Fia. Lic. No./Reg. No. Phone No. (Area Code) Esta��ishment Strunk Funeral 1623 North Central Avenue F041870 (772) 589-1000 Home and Cremator Sebastian, Florida 32958 5. C`;eck a. � The medical certification has been compl>ted and signed. A completed certificate of death accompanies this � �ppropriate application. Box t.�. � was contacted on Ne/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 medicaf csrtification of cause of death within 72 hours. c. � �was contacted on Ne/she verified that , Medical Examiner, will compiete and sign the medicai certification of cause of death within 72 hours. 6. Funerai Direi;ter! i nature .r F.E. No./Reg. Ne. Date Signed 6 0��,� `� p227gg April 13, 2012 g. �URii�L - TRAiVSIi P�RIl�I°f Permissicn is hereby granted to dispose of this body. Permit No. 0130-12-175 � A five (5) day extensiun of time for filing the death certificate (exclusive of weekends) has been requested and granted since the physician has been contacted by the fiuneral director and wii! not be able to complete the medical certification of cause-of-death section of the death certificate w�thin 72 hours. ��!o exfension of time for fili�eath certificate has been requested. c. � Subregistrar Signature Approval Nurriber: Date 4� 13 / 2 012 Date Certificate 4/� 8� Issued: Due: 1 AUTHORIZATIO[V for CRElVIATION, DlSSECTIOPJ, or Bl1RIAL-AT-SEA Date Medical Examiner, , gave authorization by telephone to Funeral Director/Direct Disposer. Date The Medical Examiner's approvai 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: �URIAL ❑STORAGE ❑CREMATION �OTHER (Specify) Signature of Sexton or Person-in-Charge �,c� C�. CEt1AETERY OR CFiEMAT013Y Place of Disposition Sebastian Cemetery � Date of Disposition April 17, 2012 This permit must be endorsed by the Sexton or person-in-charge (or by the Funeral Director/Uirect Disposer when there is no Sexton) and returned within 10 days to the local County Health Department in the county where disposition occurred. Dis*.ribution: White: Cemetery or Crematory DH 326, 8/97 (Obsoleles all previous editions) Yellow: Funeral Director or Direct Disposer (Stock Number 5740-000-0326-2) Fink: Local Registrar , _.. - _.._... - -- - , _ � _�._ _ � �-�-.--�� , _ � '� , �_ � �"o � �'t % � I V y `� � _,—_—,..� "`_-,-�_._' . . . � j • r `t � � - --->----___� 1 t� ��' '� f /� ��f_�` �� , �l� �-�'�'��-�� r, {( �� .' P1 i.i''�� . t ,� � (� , , .17 � � i � � ��' '� � � �€.9 f � ; 1 r ��} 1,3 l � .. � ��'� % .. 1 � ,f i • �t , 4 (7` / r L � � ��• �/?1,} ,�.. • � � �r'r � +¢,i / �� , �� I^a ,�l y', �.'a � f�� ... �( _ � , . 2 � � ` , 1" J ! _. ,�� '�..( 9� /U,-� // /Y �' �,,P_. � ,;� � �3 . � �.. %� ; � ��'� i� � ; _ ,' � , � i ' /� f � . � � �; '�� `� ` P', /° Y'i � ' �r� � I k. 1 _ � ,� � � �y n 3" �� r. 7 � ri` ��' � � � ��I � � , 3i i, '� \, � � U �r�+�;,_ i i ,� V I { : j % � ' ti �� ; �,� 8 I , �.' y / / �� ' , � I .. %, �� , —�-----�__ UNIT -- _ _ -_- -� .� BLO CK � --�_, LpT S— L ! OT A VAIL AB LE Fp RS AL E tnV t)F �,�,�,�sT�� '"� �� HOME QF PELiCAN ISEANIJ � � � �� 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, proof of City residency of purchaser or person for whom lot is intended for interment must be provided at time of purchase. �Q.YI ( C � �� f �' I Gf'1 L' � i � — Name(s) P[�5t C��F�F�ce �x �780815 , Se��z.s��c�n FL 3z4 �8 Address Area Code & Phone Number Name & Residence Address of Intended Occupant if Other Than Purchaser OFFICE USE ONLY Receipt is acknowledged in the sum of: �� h,e-ta � � nd. 0-�v� '�%-o on this 0�` day of V�' . Cemetery Lot(s) and/or Niche(s). Dollars ($ � 000, oo � 20 �� for the purchase of the following described Unit �, Block 5� , Lot(s) �`�' UJ 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) Temporary Marker Preparation & Installation Signature of Purchaser Interment /W O H Circle One Disinterment TOTAL $ �-F � �% � • � � of Sebastian The following documents were provided as Proof of Residency: I:\W1N-DATA\Ms-Cemetery\RECEIPT.doc I and CITY OF SEBASTWN CITY CLERK�S oFF��E � 4 5 9 9 RECEIPT Name �an i c. e. P�sf� � c h�( �� ❑ Cash Date r O��" v` I�CCheck# �QS � No. 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 Copies/Bid Specs. 001501341910 LDCICode of Ordinances Amount Paid 001501341930 ElecGon Qualiryirg Fees 601010 343800 Cemetery Lots QUQ UO LoUNiche 5'� �. Bbdc Sa . Unit �• � 001501343805 Cemetery Fees 1� W �� C,(,��/,� Total Paid � 0 Initials White - Dept of Oripin • llellow - Fin�nee • Pink - Applicant