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HomeMy WebLinkAbout4-02-22Name Unit Block Lot (g' Date of Mark -out Date of Burial—T "T' Time awovp° l` e, Pee- Name of Funeral Home✓ ^" Authorized by PATRICIA OCH Patricia Och, 71, of Sebastian! FL passed away peacefully with family at her side on February 15, 2014, after a courageous, 7 year battle with multiple system atrophy. Born February 20, 1942 in Braddock, PA, she graduated from Scott High School in 1960, studied music at Duquesne University, and studied for the Vincentian Sisters of Charity at La Roche College. A church organist from the age of 13, she directed the choir from 1980 through 1997 at her home parish of St. John the Evangelists in Latrobe, PA. She later played at St. Sebastian in Sebastian, FL, where she lived from 1997 until present. Patti was a selfless, compassionate person who without fail, gave of herself, putting the needs of others ahead of her own. Among her many interests were music, animals, hiking, drawing, and traveling, she took great joy sharing in these and all the gifts of God's creation with those around her. Above all, she devoted her life to God and her family. She will be missed immeasurably by all of us whose lives she touched. She was preceded in death by her father and mother, Paul & Ann Serbak. She is survived by her husband of 45 years, Rich of Sebastian, FL; sons, Duane of Houston, Shawn & Keith of West Palm Beach; grandsons, Nathan & Jeremy and brother, Paul. Certificate No. 2411 CITY OF DEB- 3AST1I `= 1 Certificate of Interment Rights IN ACCORDANCE with provisions of the Code of Ordinances of the City of Sebastian, it is hereby certified that: Richard Och 381 Fleming 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 2, Lots 21 & 22 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 18th day of February, 2014. CITY OF SEBASTIAN, FLORIDA Joseph F. Griffin Interim City Manager ATTEST: Sally,A. Maio, MMC City Clerk !C!4 State of Florida, Department of Health, Bureau of Vital Statistics HEA BURIAL TRANSIT PERMIT DATE PRINTED: February 18, 2014 TRACKING NUMBER: 2014024747 1. DECEDENT INFORMATION Name of Deceased Date of Death PATRICIA S OCH February 15, 2014 Place of Death - County City, Town or Location Name of facility, or street address if not a facility INDIAN RIVER SEBASTIAN SEBASTIAN RIVER MEDICAL CENTER 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: 2014- FO41870 -5028 t Date Issued: February 17, 2014 �c 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 Place of Disposition: SEBASTIAN CEMETERY k 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 CITY OF SEBASTIAN CITY CLERK'S OFFICE 4848 RECEIPT Namea„)1 1 Unk oCk ^ � Date o _ / q- q No. 001001208001 001501 322900 001501341920 001501 341910 001501 341930 601010 343800 001501343805 ❑ Cash Check# Amount Paid Sales Tax Garage Sales Copies /Bid Specs. LDCICode of Ordinances Election Qualifying Fees Cemetery Lots Lot/Niche , Block , Unit _ Cemetery Fees o C %IMM Alw�� �j Total Paid ( /.✓0 • ®6 Initials White - Dept. of Origin • Yellow - Finance • Pink - Applicant FUNERAL HOME 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 Strunk Funeral Home and Crematory ADDRESS: 1623 North Central Avenue, Sebastian, Florida, 32958 PHONE #: 772- 589 -1000 (Check One) X OPEN BURIAL LOT OPEN CREMAINS LOT OPEN COLUMBARIUM NICHE Lot 22 Block 2 Unit 4 Lot Block Unit Niche Block Unit N S E W BURIAL DATE AND SERVICE TIME: wed., 02/19/2014 —10 AM Church service FOR DECEASED: Patricia S. Och Name NAME AND SIGNATURE OF LOT OWNER OR REPRESENTATIVE: st 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 DIRECTOR: Tim Marvin �— kn)WLII M ILA 1 Name Signature � i8 /j4 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: C me ry SVtoV Date/ This form to be provided to Cl s Office by Sexton for permanent record upon completion. CITY OF SEBASTIAN CITY CLERK'S OFFICE 4845 RECEIPT Name �� L1 ❑ Cash Date 2 ❑ Check # No. Amount Paid 001001 208001 Sales Tax 001501 322900 Garage Sales 001501 341920 Copies /Bid Specs. 001501 341910 LDCICode of Ordinances 001501 341930 Election Qualifying Fees 601010 343800 Cemetery Lots 2J -)G0 4' c) {� Lot/Niche 1G 2, Block _ , Unit I 001501 343805 Cemetery Fees (1`' r -�'✓`2 Total Paid'' f � Initials White - Dept. of Origin • Yellow - Finance • Pink . Applicant