The URL can be used to link to this page

Home My WebLink About4-06-20Name /T i Unit Block Lot Date of Mark -out Date of Burial lic�Z7 Z :5 • Time Name of Funeral Home` � Authorized by �Vl`� _ �` 4rAL CFFYOF !,ISTL SEBA HOME OF PELICAN ISLAND Certificate No. 2399 CITY Of SEB --)TIA V Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Patricia A. De La Marche 413 Thomas Street Sebastian, FL 32958 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 6, 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 26th day of December, 2013. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin Interim City Manager ATTEST: Sally A./Maio, MMC CiK Clerk Total Paid 150.6)6 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE RECEIPT 4827 Name : a f'l � a / i ar h [I Cash 15� / Date G � d' X Check # `�1 7y 9 No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies /Bid Specs. 001501 341910 LDC /Code of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots ' l / �// Z0 -T LoUNiche , Block ( Unit i 00 001501 343805 Cemetery Fees • rr�� C. k Total Paid 150.6)6 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant Total Paid Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant CITY OF SEBASTIAN CITY CLERK'S OFFICE 4826 �J RECEIPT CI Cam/ De (J-�. �Lr"he -❑ Name I`G'`f Cash Date 1 ZI Z6! 13 check # 36 No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies /Bid Specs. 001501 341910 LDC /Code of Ordinances 001501 341930 Election Qualifying Fees ` 601010 343800 Cem tery Lots 2-C, ! 1-:24lC�� fiche , Block Unit 001501 343805 Cemetery Fees Total Paid Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant ALFRED L. De LaMarche Alfred L. De La Marche, 75, went to Heaven peacefully on December 21, 2013 at his residence in Sebastian Florida. He was born May 10, 1938 in Peekskill New York and lived in Brigantine NJ for 34 years before moving to Sebastian, Fla in 1994. Mr. De La Marche was a US Navy Veteran and retired as a Radar Engineer for the FAA after 31 Years and was a member of St. Sebastian Catholic Church. Survivors include wife Patricia A. De La Marche of Sebastian of 54 years, son Stephen A. De La Marche of Smithville New Jersey, daughter Michele P. De La Marche Dancy of Sebastian, Husband Edward C. Dancy III. Sister Audrey Desposito of Somers, New York. Granddaughters Lauren M. Dancy, Samatha G. De La Marche (Zac) and great - granddaughter Riley Jo Wilson, Mason, Ohio. Also surviving are his nieces and nephews from the DeRosso and Desposito families and predeceased by his grandson Nicholas L. De La Marche and parents Louis and Anna De La Marche. Other than his family, Big AI's true passions in life were fishing, crossword puzzles, his tomato garden and sharing his life's stories. E1 OR1Hi7II�,4R[Gt>,1TgF'. / State of Florida, Department of Health, Bureau of Vital Statistics HALT 47 BURIAL TRANSIT PERMIT DATE PRINTED: December 23, 2013 TRACKING NUMBER: 2013180738 1. DECEDENT INFORMATION Name of Deceased Date of Death ALFRED L DELAMARCHE December 21, 2013 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER SEBASTIAN 413 THOMAS STREET 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. TIMOTHY W. MARVIN F022789 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: 2013- F041870 -5166 Date Issued: December 23, 2013 Meade Grigg, State Registrar I AUTHORIZATION for CREMATION, DISSECTION, BURIAL -AT -SEA, or HOSPITAL DISPOSITION Authorization given by Medical Examiner District Approval Number: 4. CEMETERY OR CREMATORY Place of Disposition: SEBASTIAN CEMETERY Method of Disposition: BURIAL Date of Disposition: EDRS maintains all statutorily required information regarding the death record and related burial transit permit, therefore, returning the permit to the county health department is no longer required. If the Place of Final Disposition wishes to retain the copy of the permit for their file they may do so. DH 326E, 10/12 64V- 1.011, Florida Administrative Code FUNERAL DIRECTOR'S REQUEST TO CITY OF SEBASTIAN FOR BURIAL OPENING IN SEBASTIAN MUNICIPAL CEMETERY For information contact: Kip Kelso Cemetery Sexton Sebastian Municipal Cemetery (772) 589 -2545 City Clerk's Office City Hall, 1225 Main Street Sebastian, FL 32958 Office (772) 388 -8215 or 388 -8214 Fax: (772) 589 -5570 FUNERAL HOME: Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE #: 772- 589 -1000 (Check One) X OPEN BURIAL LOT LotZoBlock 6v Unit OPEN CREMAINS LOT Lot Block Unit OPEN COLUMBARIUM NICHE Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: /"adz_ -7//S FOR DECEASED: / �l -,�2� Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: (Must provide proper documentation of ownership) Name 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 DIR TOR. Tim Marvin Name ignature 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 ave -been paid: Ce'meiery boxtorl Date This form to be provided to CI k's Office by Sexton for permanent record upon completion.