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Home My WebLink About4-11-23Cf(Y OF �,�1��►��1��,]� :__ . . HOME OF PELICAN ISLAND Certificate No. 2226 I � 0� � �� ' �r. <<''� � � <<''� Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Winsle Newcomb 868 Waterway Drive, Barefoot Bay, FL 32976 (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, Blk 11, Lots 23 & 24 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 6th day of July, 2009. CITY OF S�BASTIAN, FLORIDA �AI Minner City Manager ATTEST: G ` � 1 Q �� Sally . Maio, MMC City Clerk Name w �NS.�(� �� C�r��r9 /c> '� X� � � � � � Unit "� Block�_ Lot _� Date of Mark-out � --�� - . - -- Date of Burial 7 �� %�.. Time � � �� • Name of Funeral Hom Authorized by 0 0 a � � � 0 0 o z � d c ° ° � � o � `D � o j o � � ° ° (,.) w w �"' o � � � N � � � � N � � p0 � � p O i � � � o � ^' v � � � i � � z � � c� °� m -a O � Fi rp � � � x '.°. � m .� � m 5. �� O � � O y n � ,o l � � 5 � v � � • � �d � y N � � f � � � T � Y f'Y m �. � • _ � C � N • 7 C�f � � O � 9 � � � � �N 7 6 /1 � `., ,•/ Cl'�r- 7 � i�- a � � � y G n � � mmo m�m .�N� -�0� T �„� T C y I m= W'^ V 1 U WINSLE NEWCOMB February 4, 1933 - September 12, 2012 Mr. Winsle Newcomb, 79, died September 12, 2012 at his residence in Barefoot Bay. Mr. Newcomb was born in Harrisburg, IL and lived in Barefoot Bay coming from Phoenix, AZ in 2006. He was employed as a Cook for Brach's Candy in Chicago, IL. Survivors include his son, Robert Newcomb of Phoenix, AZ; daughters, Elizabeth Smith of Sebastian, Hazel Garcia of Phoenix, AZ, and Sandra Finnigan of Cicero, IL; brothers, Henry Newcomb of Elgin, IL, Willard Newcomb of Harrisburg, IL and Donald Newcomb of Joliet, IL; 7 grandchildren, 6 great grandchildren. He was preceded in death by his wife, Ann Newcomb. - -� FLORID3DFPARC64E`+i OF �. ,.' State of Florida, Department of Health, Bureau of Vital Statistics HE�I�T BURIAL TRANSIT PERMIT DATE PRINTED: September 13, 2012 TRACKING NUMBER: 2012125753 1. DECEDENT INFORMATION Name of Deceased Date of Death WINSLE NEWCOMB September 12, 2012 Place of Death - County City, Town or Location Name of facility, or street address if not a facility BREVARD BAREFOOT BAY 868 WATERWAY DRIVE Name and Address of Funeral Home/Direct Disposal Establishment Fla. Lic. No./Reg. No. Phone Number STRUNK FUNERAL HOME- SEBASTIAN F041870 F041870 (772) 589-1000 1623 N CENTRAL AVE SEBASTIAN, FLORIDA, 32958 Funeral Director/Direct Disposer Fla. Lic. No./Reg. No. R. MARSHALL VOYLES JR F043488 2. BURIAL - TRANSIT PERMIT The Florida Department of Health, Bureau of Vital Statistics hereby grants permission to dispose of this body in accordance with Chapter 382, Florida Statutes. Permit Number: 2o�2-FOa�s7o-5o5z . QG / �� • Date Issued: September 13, 2012 G`• � J Meade Grigg, State Registrar 3. AUTHORIZATION for CREMATION, DISSECTION, BURIAL-AT-SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY PI8C2 Of DISpOSItiOn: SEBASTIAN CEMETERY �� Method of Disposition: BURIAL Date of Disposition: I� � ign ure of exto or person-' -charge (or by the funeral director/direct disposer when there is no sexton) DH 326E, 1/11 64V-1.011, Florida Administrative Code FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING !N SEBASTIAN MUNICIPAL CEMETERY �� HOME OF PELICAN KlAii] For information cantact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery (772) 589-2545 City Clerk's O�ce City Hall, 1225 Main Sf�eet Sebastian, FL 32958 O�ce (772j 388-8215 or 388-8214 STRUNK �UNERI�La�iO��iB�I�E��A3��tY FUNERAL H�ME: 1623 No. Cent�al Ave. , ADDRESS: �772y 589-l000 PHONE #: ( h One� i OPEN BURIAL LOT Lot �� Block ( 1 Unit _� OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit � BURIAL DATE AND SERVICE TIME: � u�� I� � I� E'--' FOR DECEASED: I n� �� Q,WCDI�YI� Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership} � �I i2Lt,b�i� i�nn Sh�l ' R I� �Z Name S nat e 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 openi g of same. iVAME AND SIGNATURE OF LICENSED FU Dt E OR: M c��hcu t�o I.�S � i3 i� __�__1 Name Signatu Date ------------------------------------------------ Cemetery Sexton Certification: I certify that I have checked the ownership inforrnation by viewing the owne�s deed and confirming with Clerk's office and E at II fees have been paid: , Cemet ry Se on Date This form to be provided to Clerk's Office by Sexton for permanent record upon cornpletion. c�Y oF �� . H�ME C3f FELdCA�I (5i.A1�lU City of Sebastian Nlunicipal 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. � i n 51 e. �U � w c�o rm I� Name(s) - - - _ �, � . �, .� . �. - - 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: � ►� Dollars ($ Q DO �� on this. � day of �(�l � y , 20 U�l for the purchase of the following described Cemetery Lot(s) and/or Niche(s). r Unit T, Block�_, Lot(s) Z3 � z� 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 ��(� ,DO Vase and Ring for Niches (cost) Temporary Marker Preparation & Installation Signature of Purchaser Interment /W O H Circle One Disinterment TVTh� �P � I� V D O � � • V v ity of Sebastian The following documents were provided as Proof of Residency: !:1NM!-DATA\INs-CemeterylRECE1PT.dor. I and CRY OF SEBASTIAN �� E��S oFF��E . 4 5 6 5 RECEIPT Name (N��'I:S 1 e. IUGwCom b ❑ Cash Date � '�� '� � / ❑ Check # ? 13? l 7 F! No. � n � � A�unt Pa1d 001001208001 Sales Tax 001501322900 Garage Sales 001501341920 CopieslBid Specs. 001501341910 LDCICode of Ordinances 001501341930 Election Qualitying Fees 601010 343800 Cemetery Lots f"�(�.Q� U� ` iche L3 Zy . Block � � . Unit� 001501343805 Cemetery Fees �� WLJ�% � Total Paid "f � �Q. DO Initials White - Dept of Ori�in • Yellow - Fin�nce • Pink • Applic�nt Sep 26 2008 2:45PM HP LRSERJET 3200 FUNERAL OIRECT R'S REQUEST TO CITY OF SEBASTIAN FdR BURIAL OPENI G IN SEBAS7IAN MUNiCIPAI. CEMET�RY . S�� . . no�u u rr.KN. isuwo ' � Fo: infa�matior. contacl: Ki K�l;o - Camdtay Sextan . Se}' astian Municlpal Cernafery I f772)589-2545 FU�tiERAL HOME: ADDRESS: PHONE #� (Che One) OPE1V BURIA� LOT .�PEN CREti1AINS LOT ..._._OPEN COLUMBARIUM NlCHE BURIAL DATE AND SERV!C� 71ME: f0� OECEAS�p: Ann E. —._.__, ivdr.7e :VAM� RN� SIGNAT�RE OF LOT OW (PAus,�irovide proper doQum2ntation of Narne I certi(y tnat I have �etemiined the owri� admini:trative fees have been paid and �IA'�tE AND SIGNATJ� pF LlCENSE � � � � City Clerk's U;l�ce 'y flal�, f?25 Ma+n �rraet Sabas.tian, FC 32958 (77?) 398-8115 or 38d-8214 Faz: (77?} 58S•55YG 1 23 No. Centrat Ave. �� _.�,_Block - �� Unit �_ �._.,,__._Ei�ock Uhit iche 81ock ""--'Unit —"- --- _ -- W � 7/2/2009 – 2 P.M. .._._ p.l R OR EPRESEVT'A i !�: � ner5h ��1�Signat� e Date ship oi ;he abo �e described sir� Iha� aii site fees and �uthorize apening of same/ FUNER�,I,/DI�tEC,i'fjfi,�, � ' 1//�� -�.a�' rvarne �igna t "' Cernetery Sext�n Certification�------------ - ----•--------.----- •---•-----------..__.------------- Oate._..---• I certify lhal I hava �hecksd the ovmers ip ir�forrl;at�on b� viewing the t�wner's Ceed and contirm;ng with Clerk`s oPiice ��nd that a!I feQS have een pa�d ` . �Op- e e�er ex , � �, Oate ThiS forrTi to be prov)de� to Clerk's Off.c by Sexton for permanert record uFon comptet�on. � 0 � -r .. � . . '� � � � � ��st�� 1207 US Hwy 1* Sebastian, FL 3295$ Phone:772-589-9311 Fax:772-589-9312 ATTN: Kip Cemetery Sexton City of Sebastian For Sebastian Cemetery Phone: 772-589-2545 Fax: 772-228-9927 Size: 3� o 0 6 2-� � . w. 1 • Names & Dates: � .� � ��'�' Cn� .� Legal Description Sectio n: �lK ' T 7' Block: � r _ ��'�'��' � � Lot: � � - Space: Replat: Squa re Ft.: Approved: ?��°-y�,1� �Olr�,L� a f ovi✓d itrW /✓ y Y� �� 4T'o�,t �r -� d•� /� ; Checked By: �Qi • !� . Date: / , a l hereby certity that the ariginal of the foregoing was faxed to the Sebastian Cernetery on 1.� 13�� Everlasting Stoneworks By: Jamie Hicks �� 23 ,o . � �s /� ��L E� �� 3/z c��a 6'd Z6�6689ZLLl s�aoMeuo;g 6ui;se�aen� d£0��0 Ol £l uef Z�d � � � � � � 7 ,` � �� Z�£6685ZLLl � � � � � �i � � � � � � � � � � � � � � � d� � � r°� � � � � a � 0 � � � ° � ` �� a ! � � � � / �° � / a � / �i"1 � � � �. � � � � � C�° � ❑ � . � � � Q' � J � _� Y �, W � � � �� I � `� [.f) � � ,� � �I � � [ '" ;o �� x �'�� ;y ',� � � � � � ��Q � � R�e � � ' ' a � � M* � � � � � s�aonneuolg 6ui�se�aen� d£0��0 OL £L u�('