HomeMy WebLinkAbout4-11-20CfTY OF
~~ L~~~
_ r. .~^
1~f T
HOME OF PELICAN ISLAND
Certificate No. 2212
Certificate of Interment Rights
IN ACCORDANCE with provisions of the Code of Ordinances of the City of
Sebastian, it is hereby certified that:
Helen Colletti 7350 129t" Street, Sebastian, FL 32958
(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 lots:
Unit 4, fBlk 11, Lots 19 & 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 3rd day of April, 2009.
OFD ~iEBASTIAN, FLORIDA
AI Minner
ity Manager
ATTEST:
Sal A. Maio, MMC
City Clerk
Name .~~ ~~
„~;~
V
~.\t~
"`- )
~El ~..~ .
Block
Lot
Z t-
.~ (~ ~ ~'
Date of Mark-out
Date of Burial Time
~~
Name of Funeral Home '"~ ~ ~ `~ L ~,~
~.
Authorized by ~w:----~C ~+' ~(` G~''~"~~,~...~'7L~:~-~
Obituaries ~ Death Notices ~ Newspaper Obituaries ~ Online Obituaries ~ Newspaper D... Page 1 of 1
THOMAS ]AMES "TOM" COLLETTI SR.
Thomas James "Tom" Colletti Sr., 75, died April 2, 2009, at Sebastian River Medical
Center, Roseland. He was born in Jamesburg, N.J., and lived in Sebastian since 1972,
coming from Toms River, N.J. He was the owner/ operator of Collettti Broth ers in
Jamesburg and Toms River. He was a member of St. Sebastian Catholic Church and a
member of the Italian- A,A^ American Club, Sebastian. Survivors include his wife of 56
years, Helen Colletti of Sebastian; sons, Vincent P. Colletti, Stanley Colletti and Thomas
Colletti ]r., all of Sebastian; daughter, Christine Colletti of Sebastian; 16 grandchildren;
and seven great-grandchildren. He was preceded in death by his brother, Vincent Colletti.
SERVICES: Visitation will be from 6 to 8 p.m. April 6 at the Strunk Funeral Home,
Sebastian. A Mass of Christian burial will be celebrated 11 a.m. April 7 at St. Sebastian
Catholic Church, Sebastian. Burial will follow in Sebastian Cemetery, Sebastian.
Published in the TC Palm on 4/4/2009
Today's. TC Palm obituaries and death notices
Questions about obituaries and death notices or Guest Books?
Contact ~egacy.com • Terms of use
Powered by ~~t1G~.GOCY1.
obituaries nationwide
Back
http://www.legacy. com/tcpalm/Obituaries.asp?Page=LifeStoryPrint&PersonID=125708... 4/8/2009
04/03/2009 03:18 5615892583 STRUNK FUNERAL HOME PAGE 01
Ssp 26 2008 2s~5PM HP LiiSERJE7 3200 p.~
FUNERAL DIRECT R'S REQUEST TO CITY OF SEt3AST1AN
FOR BURIAL OPENI GIN SEBASTIAN MUNICIPAL, CEMETERY
SE ,,
I+OW V IIIKAMIMAMD
Fo: info:m~tior. cv~uact:
Ki KQ:so • Cemetery Serlorr
Se ertian Municlpa/ Cemstery
(77?J 5AD•?5<g
I Crry ~ISrN s ~'f,ce
Iry hr0%, 1728 Meirt SI/eet
SeDasuan, FL 3?S58
Oldc (r7T) 3da•82t1 o/3e8-B2t4
Fax' (77?) S84.35'G
FU!~ERAL HOME. STRUNK FUG ER,~i. HOME~6 CREMATORr
ADORE SS;
PNDNE q;
(Cheat One)
_ x .OPEN t3URIAl LOT L
OPEN CREhtAIn~S LOY L
OPEN COLUMBARIUM NICHE ~
BURIAL Dr~TE AND SERVICE 'TIME
~t `~6tock 11 Unit 4
rt ~~~ 131ock Unit ~-
cho 61ock ""'-"Unit ~~!
~~ ~ ~~~
4/7/09 11 a.m. ~^-
r•'GR OECEf~S~D; TFwmas J. Colletti, 5r.
Ivrsr"te
:SAME ANO SIGNAT;;RE OF LOT OW ER OR REPRESEVT'ATIVE:
~
(Must provide proper docur»entatiort of wnership)
Helen Colletti ~ 4/7/09
Name ~ SlpnBture ste~-
I cerlily t,~at I he~~N yelerrnined fhe sane snip of the 6bcve deSCribed si!.e II'tdl all site tees and
adrninislrUtive tees have been paid ahd uthoriie opening Of carne
NA'~1E ANi7 SIGNATJR6 OF LICENSE
i p FUNERA E 7
David L. Hlncetnatn /7/09
Marne ~gnalu o Dats
Cemetery Sexton CeAliication:
t cenlty that I nave checked th° ovrners ip +nlont;auon by viewing lhrt owner's Gees and conOrminq
with Cierk s ottictr atn Ina 4 feos have
l een paid
b
e Nery exto ate
TAis fOrrir to be provideG to Clerk's Ofl.c by Sexton for permanerl redorG uFun cot~pietron.
FLOR[DA DEPARTMENT OF
HEALT
A• (TYPE)
State of Florida, Department of .Health, Vital Statistics
APPLICATION FOR BURIAL -TRANSIT PERMIT
~. IYGIIIC VI
Deceased
1-irst Middle
Thomas James
c. dace of Death
County
1 ndian River
c. ^
3. Name of Medical Addre.
Certifier R er Mittleman, M.D. C. .E.
Medical Examiner Physician
BURIAL -TRANSIT PERMIT
4. Name of Funeral Homel9Mee~9iepeesl Address 1623 N. Central Ave.
Establishment Sebastian, FL
Strunk Funeral Home~~ Cremato
5. Check a.
Appropriate
Box
was contacted on
He/she verified that
Medical Examiner, will complete and sign the
me certi of cause of death within 72 hours.
6. Funeral Director/ S' n F.E. No./Reg. No. Date Signed
Feet-2i~eser 44048 4 /3 /09
B.
Permission is hereby granted to dispose of this body. Permit No. 1228-09-0162
^ 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.
ger'm' Date Date Certificate
SubregistrarSignature M C~.Q Issued: 4/3/09 Dye: 4/8/09
~~ AUTHORIZATION 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. Awaiting period of 48 hours after death is
required for all cremations.
D.
Method of Disposition:
BURIAL
^CREMATION
Signature of Sexton
or Person-in-Charge
City, Town ortocation
Sebastian
Fla. Lic. No./Reg. No. Phone No. (Area Code)
1228 772-589-1000
The medical certification has been completed and signed. A completed certificate of death accompanies this
application.
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.
^STORAGE
^OTHER (Specify}
_~4~ Q~
CEMETERY OR CREMATORY
.Place of Disposition Sebastian Cemetery
Date of Disposition ~~~~b ~.
Last Date Month Day Year
of
Colletti Death April 2 2009
Name of (If neither, give street address)
Hosp. or
Inst. Sebastian River Medical Center
2500 S. 35th Street Phone Number
Fort Pierce, FL 772-464-7378
< }~ .
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.
_ _ - Distribatiortr_.- Vtlk»terGemeleryorCrematoq . ... .. ..
DH 326, 8/97 (Obsoletes all previous eddions) Yellow: Funeral Director or Direct Disposer
(Stock Number: 5740-000-0326-2) Pink: Local RegisVar ,~ i~ ~