The URL can be used to link to this page

Home My WebLink About4-04-02Certificate No. 2269 CITY OF SEBASTIAN Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Charles J. Burnett 674 Kroegel Avenue, 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, Block 4, Lots 1 & 2 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 21St day of September, 2010. CITY OF SEBASTIAN, FLORIDA Al Minner City Manager ATTEST: f r, Sall . Maio, MMC City Clerk FLORIDA DEPARTMENT OF 1 OR�11 LT 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 Lorraine Burnett Death 09/21/2010 2. Place of Death City, Town or Location Name of (If neither, give street address) County H or Indian River Sebastian Inst. 674 Kroegel Avenue, Sebastian, FL 3. Name of Medical Address Phone Number Certifier Michael Venazio, M.D. 8005 83rd Avenue 1772/388-2110 Medical Examiner hysician Sebastian, FL 32958 4. Name of Funeral Home /Direct Disposal A7I2�s N. Central Avenue Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment Strunk Funeral Homes 6 Crematory Sebastian, FL 32958 F041870 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. ® Christina was contacted on September 21, 2010 He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Michael Venazio, M.D. will complete and sign the medical certification of cause of death within 72 hours. was contacted on medical certification of cause of death within 72 hours. He /she verified that Medical Examiner, will complete and sign the 6. Funeral Director/ b6WILA Si��att�re I � r• �� .E. No.JReg. No. Date Signed /'Y Lr I�.J}- 1(qy,� 17044048 09/21/2010 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228-10-0639 IR 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. F-1 No extension of time for fill eath certificate s been requested. Behr or "' f Date Date Certificate Subregistrar Signature Vv Issued: 06/2112010 Dqe: 06/25/2010 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 BURIAL STORAGE Date of Disposition FICREMATION OTHER (Specify) Signature of Sexton 1 S or Perso n n -in- Charge j} S>' /,J/ /" C n) 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 - 000 - 0326 -2) Pink: Local Registrar Rrr,,,W �� NP, Strunk Funeral Home & Crematory: Obituaries Strunk Funeral Home & Crematory LORRAINE BURNETT (September 20, 1944 - September 21, 2010) LORRAINE BURNETT Mrs. Lorraine Burnett, 66, died September 21, 2010 at her residence in Sebastian. She was born in New York City, New York and lived in Sebastian for 8 years coming from Palm Springs, Florida. She enjoyed working as a Bartender in numerous clubs throughout her career. She was a member of Saint Sebastian Catholic Church, Sebastian. Survivors include her husband of 46 years, Charles "Chuck" Burnett of Sebastian; son, Greg (Dana) Burnett of Jupiter; daughters, Gina Mazzella of Sebastian, Patti Olejniczak of West Palm Beach; brother, William Bottcher of New Bern, NC; 3 grandchildren. SERVICES: Visitation will be 5 - 7 pm on September 23, 2010 at Strunk Funeral Home, Sebastian. A Mass of Christian Burial will be 11:00 am on September 24, 2010 at St. Sebastian Catholic Church, Sebastian with Father John Morrissey, celebrant. Burial will be at Sebastian Cemetery, Sebastian. Back Page 1 of 1 http: / /www.meaningfulfunerals. net /fh/print.cfm ?type= obituary &o_id = 709011 &fh id =... 9/21/2010 Sep 26 2008 2:45PM HP LASERJET 3200 FUNERAL DIRECT R'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY SEBASTW)v how U Pf cAh isWrp For information. contact: Kip Kelzo - Cemd!ery Sexton Se p astian Municipal Cernefery r (772) 589 -2545 I ' City Clerk's Office r-y Mall, 1225 Main 8freet r Sebastian, FL 32958 Offic� (772) 388 -8215 or 383.6214 Fax: (772) 589.5570 FJVERAL HOME: ADDRESS: PHONE #: (Che One) OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE BURIAL DATE AND S ERV!Ci; 'TIME: FOR DECEASE i D: j� name NAME AND SIGNATURE OF LOT OW. (Must provide pro er documentation of Name I certify that I have determined the owns administrative fees have been paid and No. Central Ave. !7 rf7r� ■ it Block � Unit_ �t Block Unit che Block -r URIt �� E RE SEVl'ATIVE: wne) i Signature Date ;ship of the above described site Thal all site fees and uthorize opening of same NAME AND SIGN A7�E OF LICENSES FUNS } pi �-�ie LIB: Al k, - -- - - - - -- - -- - - -i- - ..5rgnature..._ -. -- -- - Cemetery Sexton Certification- . cer y t .at , have checked the oVmersqip inf0r1,;at1011 by viewing the owner's deed and confirming with Clerk's office and that all fees have peen paid Cemetery Sexton, This form to be provided to Clerk's Off.c, AK L ,ATW /1,2 Date by Sexton for permanert record upon comp;etion. p- 1 Name Unit y Block Lot Date of MarK -ouI %f G1s Date of Burial 71-9 � p Time Name of Funeral Home S Igu Authorized by City of Sebastian Sch „tiun Cemetery Pit. N 1(772) S89 . 25 45 Fax 8 1(772) 228.9927 �utc Tbi, Is tnr Infurmalianal purpose, reguarding Alunutncnls .t Scbnsllan Centctcrx \tile ' I'his is for a Double Nlarker under 2ft. S over 2 ft. ( over 2 17. is a poured foundation ) ' I'Ira,c rclurn In ('its' Of seha,ltin Sebastian ('enutert 1921 \urth Cenlril Awe. Foundalion tuture(I 32958 b }, : jamie h. Attention Cemetery Scvto„ date 10/7/10 antic tn,l.tllcd hs ; ben �1re Base : Die : doll 12/8/10 ti �nuc & U�Ir, Ilia charles burnette Iler lorraine burnette D.O.B. 1943 D.O.B. 1944 D.O.D. ( D.O.D. 2010 Unit: 4 Blk.: 4 Lot : 1 , 2 Square Feet: _ Approved: K.C.K. Checked By : K.G.K. Date: 12/8/10 By: everlasting 81, THICK 8 Picture A/0 Muuuutent in question ) WIDE Oct 01 10 04:00p Everlasting Stoneworks �S l C ' C \ D 1"Z. V �'1 y r � G c ; r � r � g, CD a me z N 3 „�,�` .,o N 0 io I vO� A na m N V N P x r 0 D D + D rn 3 r cn Q u fir.•./ 3 �U3 . O 0 Z 3 C 3 o03 rn O p Z f �o� o En XX D D Z D z v rn 17725899312 I VVLVVIIJG Eti PA � + O M�4 fir.•./ Eti PA