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Home My WebLink About1-34-18 Paid by CEMETERY Receipt No 442 Dated 6/25/86 NO. List Price$ $7Q O..AO.. Maximum No.Purim Spaces 2 Net Paid$ $700. 00 Monument permitted -Flat- Unit #1 lU1083 Rosalie J . Filomio , . Block # 34 8615 95th Ave . Lot ' s 1 R R 1 9 (Data above this line for city Record only) Fla . 3 Lot ' s # 18 DEED # 1083 & 19 Block # 34 Unit # 1 Rosalie J . Filomio 8615 95th Ave . Sebastian , Fla . 32958 Vincent Filomio, Sr. , interred - Lot 18 - 11/26/88 Name /A! ENr riL OV ✓ D Unit Block 3 Lot / Date of Mark-out // j 8 Date of Burial // _ 6 • Time Name of Funeral Home / /U - Authorized by ______. _ ---._.--________ ,..______ -- I+ S STATE OF FLORIDA `35/ DEPARTMENT OF HEALTH & REHABILITATIVE SERVICES VITAL STATISTICS 0 J ` '''"L;!..1 "tn""n"° APPLICATION FOR BURIAL—TRANSIT PERMIT nr.nwurnn.r vrvx�s A. (Type or Print) 1. Name of First Middle Last DATE Month Day Year Deceased OF VINCENT JAMES FILOMIO, SR DEATH November 23, 1988 2. Place of Death City, Town or Location Name of (If neither,give street address) County Hosp. or Indian River Vero Beach Inst. Palm Garden Nursing Home 3. Name of Medical Physician Address Phone Number Certifier Muhammad Farooq, M.D. ❑ Medical Examiner 777-37th St. Vero Beach, Fla 567-2277 4. Funeral Home/ Name Address Phone Number (Area Code) tOimemotispossr Strunk Funeral Home 1623 N. Central Ave. Sebastian, Fla 407-589-1000 5. Check a ❑ The medical certification has been completed and signed.A completed certificate of death accompanies Appro- this application. priate Box b 0 Nurse was contacted on 11/23/88 within 72 hours after death. He/she verified that this death was from natural causes, that there was no accident nor other external cause of death,and that Dr. Farooq will complete and sign the medical certification of cause of death. c ❑ was contacted on . He/she verified that , Medical Examiner, will complete and sign the medical certification. 6. Funeral Director/ Signature Fla. Lic. No./Rem--Nor Date Signed 8+teet-B,apecos / €.•y., /4.72 //- •2..f•II B. BURIAL—TRANSIT PERMIT Permit No.1228-88-495 Permission is hereby granted to dispose of this body. ❑ A five day extension of time for filing the death certificate (exclusive of weekends) has been requested and granted as undue hardship would result from filing within the normal time limit. If the certificate cannot be filed within this extended time limit,a"Funeral Director/Direct Disposer Report"will be filed with the Local Registrar of the County in which death occurred. ❑ No extension of time for filing th eath certificate requested. Registrar or Date 11/23/88 Date Certificate Subregistrar Signature - Issued: Due: C. AUTHORIZATION for CREMATION, DISSECTION or BURIAL—AT—SEA Signature , Medical Examiner Date or 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 ❑ STORAGE Date of Disposition ❑ CREMATION ❑ OTHER (Specify) Signature of Sexton ) or Person-in-Charge ► 4 ,- //�� f 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. HRS Form 3211,Ant 47(Replaces May 86 edition Which may be used) • QIitg of 3►rbaiiti• TenteterJ Drell NO. 1033 •THIS INDENTURE MADE TAU 2 I',t h day of June A. D, 110 , between the City of Sebastian, a municipal corporation existing under the laws of the State of Florida, as Grantor and RoSal.ie..J....F.i.l.om.ia 8615 95th Ave . Sebastian , Fla . 32958 of the county of Indian R i y e r awl State of F 1 a r.i.d a as Grantee, WITNESSETH: That the Grantor for and in consideration of the sum of$ 7 Q Q.Q Q to it in hand paid, the receipt whereof is herewith ao- knowledged,does by this instrument grant,bargain,sell,release, wnvey and confirm unto the Grantee heirs,legal representatives and assigns the following property situated in Sebastian,Indian River County,Florida,to-wit: All of Lot(s) 1 8&19 Block, 34 ,UNIT I of Sebastian municipal cemetery as per Plat Number 1 thereof recorded in Plat Book 2, at page 65 of the public records in the office of the Clerk of the Circuit Court of St.Lucie County of Florida;said land now lying and being in Indian River County,Florida. To Have and to Hold the same forever;provided that said property shall be used solely and exclusively for the interment of the human dead and shall be used, kept and maintained at all times in accordance with the rules and regulations,ordinances and resolutions of the City of Sebastian,Florida,hereto- fore, now and hereafter adopted or provided for the government and operation of said cemetery. The conditions,restrictions and requirements contained in this instrument shall be covenants running with the land. In the event of the failure of the owner of any property situated within said cemetery to ob- serve and comply with such rules,regulations,resolutions and ordinances and the conditions of the deed of conveyance thereof then the title of such owner in and to said property shall terminate and the same shall revert to the City of Sebastian,Florida. IN WITNESS WHEREOF,The said party of the first part has caused this instrument to be executed in its name and on its behalf by its Mayor and attested by its City Clerk and its corporate seal to be hereto affixed,the day and year first above written. CITY OF SEBASTIAN F • 'I• Attest: . -19— -414) e 4 ia !a--- By - ..'� 4$ q.-1 City Clerk Signed, Sealed and Delivered In t e Presence of: /l - . galak/il‘ /4•A j STATE OF FLORIDA COUNTY OF INDIAN RIVER 1 pp, 14 I HEREBY CERTIFY, That on this day of , III...., before me personally appeared ..., 'roc- and e • /C respectively Mayor and City Clerk of the City of Sebastian, • municipal corporation under the laws of the State of Florida to me to be the individuals and officers described in and who executed the foregoing coaveyance to os a4J.l..r J. ?C i L onto and severally acknowledged the execution thereof to be their free act and deed as such_officers thereunto duly authorised; and that the Official seal of said corporation is duly affixed thereto, and the said conveyance is the act and deed of said corporation. WITNESS my signature and official seal at Sebastian, In the County of Indian River and State of Florida, the day and year last aforesaid. b Notary Public, State of Florida at Large. My commission expires: NOTARY PUBLIC SPATE Of f1.0 104 MY C(!MMISSIUN EIIP DEC 10,190d t,;„tlEp TaR4 t.ENENAL INS. M. "i. s U i - A I • / THE SEBASTIAN CEMETERY City of Sebastian Sebastian, Florida RECEIPT IS HEREBY ACKNOWLEDGED OF THE SUM OF: ri-�ivtJ � q -01 Dollars ($ D D, D O ) FROM: p .5 fr L / i; J , F14... 0/7/ 0 S 6 / 5- II� nU 1 , � ,> sF4rc } 1/6_2 a �i�/�� Fyht_. 3z960 7 on this S day of Gi,c/I;5. 19&for 19 for the purchase of the following • described Cemetery Lot(sYupon the terms and conditions as stated herein: Description of Property: Cemetery Lot(s)# /L Block# 3 ' Unit# • • Purchase Price:4,61„_61„,...) � o /✓o Dollars($ 7o o. d 0 ) Terms and'conditions of sale: 4. , > - L' r, e /✓o, 6 O y`- 6 5J8e This contract shall be binding upon both parties, the seller and the purchaser, when approved by the owner of the property above described. I, or we, agree to purchase the above described property on the terms and conditions stated in the foregoing instrument: CJ The City of Sebastian agrees to sell the above mentioned property to the above named purchaser(s) on the terms and conditions stated in the above instrument. City of Seb tian Witness ! • i i