Ashland, NY · Chemung County
Building Permit Liability Affidavit
This affidavit identifies a building permit and property, states the applicant’s responsibility for job-site violations or injuries, and is submitted by the applicant in connection with the Town of Ashland building permit.
At a glance
- Issued by
- City of Ashland · Ashland, Chemung County, New York
- Notarization
- Required: sign this form in front of a notary before filing it.
- Official source
- ashlandny.com
- Blank form
- Download the PDF
- Catalogued
- Machine-readable
- JSON record · about the forms index
- licensed online notary
- ~15 min average
- Notarized PDF emailed
What you’ll need
- Government-issued photo ID
- Webcam-enabled device (laptop or phone)
- This form, ready to upload as a PDF
What this form is
The statement says the Town of Ashland and its current Code Enforcement Official are absolved from liability associated with the listed building permit. The signer also confirms completing form WC/DB-100 and accepts responsibility for violations or injuries at the job site. It identifies the applicant and property address and is used in connection with a Town of Ashland building permit; the form text does not specify when the Town requires it.
Who needs it
An applicant signing in connection with a Town of Ashland building permit needs this form to identify the permit and property and state responsibility for job-site violations or injuries.
Why it needs a notary
The form includes a “Sworn to before me” jurat, so the applicant whose signature appears on the form signs before the notary.
How to get this notarized
- 1
Download the Form
Get the Building Permit Liability Affidavit from the Town of Ashland.
- 2
Fill In the Form
Add the date, permit number, applicant name, and property address, and confirm WC/DB-100 is completed.
- 3
Book an Online Notary
Schedule a remote session with a commissioned online notary.
- 4
Sign on Video
Sign the affidavit before the notary during your online session.
- 5
Submit to the Town
Ask the Town of Ashland where to submit the notarized form.
Preview the form
The blank PDF straight from Ashland. Look it over, then upload your filled copy to start the notary session.
You’ll need ID and a webcam.
A licensed online notary will join you on video, verify your government-issued ID, witness your signature, and apply their seal. You’ll receive the notarized PDF by email when the session ends.
Frequently asked questions
- How do I complete the Building Permit Liability Affidavit?
- Enter the date, building permit number, applicant name, and property address. Confirm form WC/DB-100 is completed, then sign before the notary.
- Do I need to sign this form in front of a notary?
- Yes. The form has a “Sworn to before me” jurat and a notary public signature line. The applicant signs before the notary.
- Can I notarize this form online?
- New York authorizes remote online notarization by a commissioned online notary under Executive Law §135-c.
- Where do I submit the completed affidavit?
- The form is connected to a Town of Ashland building permit. Contact the Town about where to submit it; confirm with the city, town or village if unsure.