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HomeMy WebLinkAbout4-11-38MOF HOME OF PELICAN ISLAND Certificate No. 2218 CITYOFSEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Mr. Arthur Jones 1380 Coverbrook Lane, Sebastian, FL 32958 (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 lots: Unit 4, Bilk 11, Lots 37 & 38 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 29th day of April, 2009. OF,gEBASTIAN, FLORIDA I Al Minner City Manager ATTEST: Sally . Maio, MMC City Clerk Obituaries I Death Notices I Newspaper Obituaries I Online Obituaries I Newspaper D... Page 1 of 1 BARBARA JOAN JONES Barbara Joan Jones, 58, died April 27, 2009, at Sebastian River Medical Center, Roseland. She was born in Oswego, N.Y., and lived in Sebastian for nine years, coming from Boca Raton. She was an administrative assistant in the health care industry. She was a member of St. Sebastian Catholic Church, Sebastian. Survivors include her husband of 38 years, Arthur Jones of Sebastian; daughters, Lisa Licari of Greenacres and Andrea Willocks of Vero Beach; mother, Theresa Metz of Oswego; brother, Nelson Metz III of Oswego; sisters, Nancy Jean Ratigliano of Ballston Spa, N.Y., Margie Ravisi of Oswego and Laurie DeLuca of Hardwick, N.J.; and four grandchildren. Memorial contributions may be made to the Leukemia & Lymphoma Society, 4360 Northlake Blvd., #109, Palm Beach Gardens, FL 33410. SERVICES: Visitation will be from 11 a.m. to 1 p.m. April 30 at the Strunk Funeral Home, Sebastian. A Mass of Christian burial will be celebrated at 1 p.m. April 30 at St. Sebastian Catholic Church, Sebastian. Burial will be in Sebastian Cemetery. Published in the TC Palm on 4/29/2009 Today's TC Palm obituaries and death notices Questions about obituaries and death notices or Guest Books? Contact Legacy.com • Terms of use Powered by LegacT.com. obituaries nationwide Back http:// www .legacy.comltcpalmlObituaries. asp? Page= LifeStoryPrint &PersonID= 12667... 4/29/2009 E FLORIDA DEPARTMENT OF HEALT A. (TYPE) State of Florida, Department of Health, Vital Statistics APPLICATION FOR BURIAL - TRANSIT PERMIT 1. Name of First Middle Last Date Month Day Year Deceased of Barbara Joan Jones Death April 27 2009 2. Place of Death City, Town or Location Name of (If neither, give street address) County Hosp. or Indian River Sebastian Inst. Sebastian River Medical Center 3. Name of Medical Address Phone Number Certifier Harish Sadhwani, D. 12920 U.S. #1 Medical Examiner lPhysician Sebastian FL 772- 581 -2373 4. Name of Funeral Home/wectrm oral Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) 1623 N . Central Ave. Establishment trunk Funeral Home & Cremato Sebastian, FL 1228 772 - 589 -1000 5. Check a. U The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b. Cynthia was contacted on 4/28/09 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Dr. Sadhwani 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 medi rtifiSKio,Af cause of death within 72 hours. 6. Funeral Director/ Si at F.E. No. /Reg. No. Date Signed �c Qifi Wr 44048 4/28109 B. I BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -09 -0203 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. Registrar or Date Date Certificate SubregistrarSignature , . �. 0" Issued: 4/28/09 Dye: 5/2/09 C. 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. 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 CREMATION Signature of Sexton or Person -in- Charge STORAGE Date of Disposition OTHER (Specify) 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 4)00 -0326 -2) Pink: Local Registrar ` P-r- Sep 26 2008 2:45PM HP LRSERJE:T 3200 p,1 FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBAST 11040 to PEUCN. ISLAND Fol inforrnatior. cornact: Ki Kelso - Cemetery Sexton Se astian Municipal Cemetery So, (772) 589 -2545 STRUNK FJtiERAL HOME: ADDRESS: PHONE #: I City Clerk's office iry Hal., 1225 Main Street Sebastian, FL 32958 OlNG (772) 388 -8215 or 388.8214 Fax: (772) 589.5570 UN RAL HOME & CREMATE 162 No. Central Ave. (heok One) OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND SERVICE TIME FOR DECEASED: Barbara J i,4ume :`DAME AND SIGNATURE OF LOT OW ( "dust provide proper documentation of Name I certify tnat I have determined the ownr administrative fees have been paid and 38 Block 11 Unit 4 .r,Block Unit he Block -Unit - VV pril 30, 2009 1 P.M. Jones ER OR REPRESENTATIVE: wnership) Signat -re V D5te ship of the above described si ±e Ihat all site fees and authorize opening of sgme NA -ME AND IGNATJRE OF LICENSE? FUME D TOR. i warn to Cemetery Sexton Cerlffication Date --- -- -----------_---------------------------------- __- _----- __- _---- I certify that I have checked the ovinersr p inforn ation by viewing the owner's deed and confirming with Clerk's office and that all fees have een paid Cemetery Sexton This form to be provided to Clerk's Off Date by Sexton for permanert record upon compieaon. i� Name Unit Block Lot Date of Mark -out Date of Burial Time Name of Funeral Home Authorized by � z �o 4-7 vj (cc 1 -Ij VJ cc� f V N\10 CD