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Home My WebLink About1-09-26RICHARD MASTON "DICKIE" ANDERSON Born: October 21, 1931 Death: October 13, 2011 Mr. Richard Maston "Dickie" Anderson, 79, died October 13, 2011 at VNA Hospice House, Vero Beach. He was a lifetime resident of Sebastian. He Owned /Operated Ercildoune Bowling Lanes in Sebastian since 1966. He was a member of the Fraternal Order of Eagles and the Moose Lodge both of Sebastian; he was a member of the Elks Lodge #1774, Vero Beach. Survivors include his sons, Richard E. Anderson of Sebastian, Randall C. Anderson of Grant; daughters, Karen Vatland of Vero Beach, Kathi Neuberger of Fort Pierce; 4 grandchildren, 4 great - grandchildren. He was preceded in death by his brothers, Robert M. and Willie B. Anderson. 12/27/2011 10:59 trAA)iuoct$jfU4j 0 rA a Ch 0 0 0 0 a C5 d 10627 P.009/011 P.001 3 J W T Cco u� oozar- =H„QN Cl co W U) 12/27/2011 11:00 U) m o�� U) �zzg 03- = m r q-- 00627 P.010)011 l00'd crozzaZ90LUVA) BwoJG I a=luea0 J14S SF:S l t FA V' W, 0 �I I 0 0 w a N � o � � CA l00'd crozzaZ90LUVA) BwoJG I a=luea0 J14S SF:S l t FA V' W, 0 �I I 12/27/2011 10:59 r. S � r:7QN$g w f; _.Zia. �J CA Strunk Funeral Home Monument Installation Request Name 1 5,oM ka0z, A Cemetery Scwl&ilan ameyw Plot Location Section Block Lot Monument Type Grass Marker L�-j *-)L-D� 90627 P.000011 Slant Marker X X Base X X Bevel X X Base —X —X Upright Marker X X Base —X —X 1� Foundation Yes No a W 0 Vase Yes No 0!0'. u Vase Description_ e �� zv-w Installation Requested By C��(12. Y. Date Requested M I ZI IC! 12-0 I h Installation Completed B Y � r fit,,A/ 5. Date �12-1 (Upon completion fax to Strunk Funeral 44ome 779-9036) 12/27/2011 10:59 rrom:btar urantte Company -0-Star Qriq �1ti�� V. 0. &X 13'9 Ali OM& 111 30631 ?.• 1. 100.241 f242 f: 706.283 -7043 Sold To: SEBASTIAN CHAPEL DAVID HINCEMAN 1623 NORTH CENTRAL AVE. SEBASTIAN, FL 32958 Phone: 772.589 -1000 Fax' 772- 589 -2583 Ship Via POOL TRUCK Estimated Ship Date Terms NET 30 DAYS Freight PREPAY q Jntl Item No. Color 1 MRKBRP STAR 13LUR LETTER PER ATTACHED, BLACK LITHO REF: ANDERSON SEND DRAWING FOR APPROVAL 1 LEDGER STAR BLUE 10627 P.007 1011 70622837043 11/02/2011 14:14 0452 P.001 /001 Order Acknowledgement Acknowledgement No, S0114100 Sales Order Date; 10/26/11 Page; 1 Ship To: STRUNK FUNERAL HOME JUANITA 916 17TH ST. VERO BEACH, FL 32960 Phone: 772- 466 -1955 Fax; Customer ID 4199 Sales Quote No. P, O. Number P.O. Date 10/26111 SalesPerson KB,TR Description 2 -0 X 1.0X0.4 PFT BRP 3 -0 X7 -0 X0.6 PFT BRP Order Weight: 2,009.88 r Aeknw*1*e9WMnt 6 %91+1. unit Price Total ?4lce 94.40 94.40 478.80 478.80 Subtotal; i 573:20 Invoice Discount 0.00 Tax. 040 Total: $73.20 20 1 12/21/2011 10:59 00627 P.006 /ID11 4 -4, .. -au -- -AmnLo Blau eutu raft urass. marxer HnaerSOn, Kichard M. Page 1 of 1 __ Date: Thu, 20 Oct 2011 10:11:05 - 0400110/20!2011 10:11:05 EDT] _ _.._........ __._........,. From: richella(�sfh.us To: tree star ran�te.com _...._.._.— _.......9........_...._...._... Cc: richellefi�sthus .....- ......_.... ................. _.. _ ...... _...__.. Subject: Granite slab and Flat Grass marker Anderson, Richard M. Thursday, October 20, 2011 Good morning, Terri: i need to order the granite slab and flat grass marker for Richard M. Anderson. Here is the measurements for each: n L"M - 3 Ft wide - 6 inch thick (Granite Slab - Polished (top) 3 -0 x 7 -0 x 0 -6 sides are rough cut 1 -0 X 2 -0 X 0 -4 FLAT GRASS MARKER (grey granite) with Richard M. Anderson DOB: Oct. 21, 1931 DOD: Oct. 13, 2011 Thank you, Richelle i M krrjcrSm j5tn-t &a&s M cu'UAe--. http:// we bmail. sfh. us lhorde /implmessage.php ?actionID -print message &index =5522 10/21/20111 12/27/2011 11:00 Star Granite Co., Inc. (as Star 9"r* Q ®ronae) 0!0. eaxIS9 T- iwo -w 7E42 (F. 706 -20 -7013 Sold To: SEBASTIAN CHAPEL DAVID HINCEMAN 1623 NORTH CENTRAL AVE. SEBASTIAN, FL 32958 Phone: 772- 589 -1000 Fez: 772- 589 -2583 Ship Via POOL TRUCK Ship Date 12/07/11 Terms NET 30 DAYS Freight PREPAY Shipping Instructions Sales Order - Shipping Copy uanti Item No. Color Description 1 MRKBRP STAR BLUE 2-0 X 1-0 X 04 PFT ERP LETTER PER ATTACHED,.BLACK LITHO REF: ANDERSON SEND DRAWING FOR APPROVAL 1 LEDGER STAR BLUE 3.0 X 7-0 X 0.6 PFT BRP Order Weight: Shipp/ng Copy 10627 P.011/1011 Acknowledgement No, S0114100 Sales Order Date: 10/26/11 Page: 1 Ship To: STRUNK FUNERAL HOME JUANITA 91617TH ST. VERO BEACH, FL 32980 Phone: 772 -466 -1955 Fax: Customer ID 4199 P.O. Number P.O. Date 10/26/11 Vendor SalesPerson KB,TR 2,009.88 1133 �� d oc�CID i c I r at. r°t v v j• N --77 r� r V� r 5. Check a. F-1 The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b,.Eff' scn,\t a— was contacted on I t) S He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Prkk will complete and sign the medical certification of cause of death within 72 hours. C. 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/ Si nature a7tA� �� F.E. No. /Reg. No. �p to Sig ed F042972 `V 15 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -11 -466 ,E5-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-jNo extension of time for filing the death certificate has been requested. Reois#ar or Date Date Certificate Subregistrar Signature Issued: 10/13/2011 Due: 10/18/2011 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 CREMATOR ;, n Method of Disposition: Place of Disposition ( `W rj BURIAL RSTORAGE Date of Disposition V `' r D C�Ob6r (9.2D I' CREMATION 00THER (Specify) Signature of Sexton or Person -in- Charge 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 State of Florida, Department of Health, Vital Statistics H APPLICATION FOR BURIAL - TRANSIT PERMIT A. (TYPE) 1. Name of First Middle Last Date Month Day Year Deceased Richard Maston Anderson of October 13, 2011 Death 2. Place of Death City, Town or Location Name of (If neither, give street address) County Indian River Vero Beach Hosp. or VNA Hospice House Inst. 3. Name of Medical Richard T. Penly M.D. Address Phone Number Certifier 1265 36th Street Vero Beach, Florida 32960 Medical Examiner Physician (772) 567 -6340 4. Name of Funeral Home /Direct Disposal Address Fla. Lic. No. /Reg. No. Phone No. (Area Code) Establishment Strunk Funeral Home 1623 North Central Avenue Sebastian, and Crematory Florida 32958 F041870 772 ( ) 589 -1000 5. Check a. F-1 The medical certification has been completed and signed. A completed certificate of death accompanies this Appropriate application. Box b,.Eff' scn,\t a— was contacted on I t) S He /she verified that this death was from natural causes, that there was no accident nor other external cause of death, and that Prkk will complete and sign the medical certification of cause of death within 72 hours. C. 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/ Si nature a7tA� �� F.E. No. /Reg. No. �p to Sig ed F042972 `V 15 B. BURIAL - TRANSIT PERMIT Permission is hereby granted to dispose of this body. Permit No. 1228 -11 -466 ,E5-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-jNo extension of time for filing the death certificate has been requested. Reois#ar or Date Date Certificate Subregistrar Signature Issued: 10/13/2011 Due: 10/18/2011 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 CREMATOR ;, n Method of Disposition: Place of Disposition ( `W rj BURIAL RSTORAGE Date of Disposition V `' r D C�Ob6r (9.2D I' CREMATION 00THER (Specify) Signature of Sexton or Person -in- Charge 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 ,A L FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY ann HOME OF PELICAN ISLAND For information contact: Kip Kelso - Cemetery Sexton Sebastian Municipal Cemetery f \A (772) 589 -2545 wI FUNERAL HOME: ADDRESS: PHONE #: City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax. (772) 589 -5570 STF4�;'.i{ F 1623 RAL Cent CREMATORY alA (Che One) OPEN BURIAL LOT Lot 2I ,, � Block Ct Unit_ OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit W, BURIAL DATE AND SERVICE TIME: 1/V L p J oa �M FOR DECEASED('Chc. - I oas u' 1 l ``� (�•1� 1 L 11 Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) auxa-ila , , aV-ou"WYI R-1 ChCtv-& F::-. AyA' y'< 0-o n Db I l Name 11 Signature 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 opening of same. NAME AND SIGNATURE OF LICENSED FUNERAL DIRECTOR: - A' C, � tnn ory U-,r\ i,�— U�, A Name Signature Date Cemetery Sexton Certification: I certify that I have checked the ownership information by viewing the owner's deed and confirming with Clerk's office and that all fees have been paid: X 40 to I l/ Cern6tery ext n ell Date This form to be provided to Clerk's Office by Sexton for permanent record upon completion. Name Unit Block Date of Mark -out L71 /I/ Date of Burial 1ZL Time> < <-�"F� Name of Funeral Hom/�e / 1 Authorized by 7 N S m I 0 5 T Y O m • C> c4i °o °o o Z 0 0 � O g 7 � ei N 0 0 0 0 0 d a (�O ? "W o c CO O CO O CO O CD D O o $ °O o C> c4i °o °o o Z 0 Cn o g 0 o 0 0 0 0 0 (�O ? "W O CO OWO O COT O CO O CO O CO O CD D O n or m m v o m d m N_ N M. N n n CD CD r c M Cn N o y CD N _ 7 T 3c G Z d CD n n C m CD N [� S 3 0 d a A n mmo CA W -i O T � M 4_ N