Elmira Heights, NY · Chemung County
Workers’ Compensation Exemption Affidavit
This notarized affidavit lets eligible owners of one- to four-family owner-occupied residences document a workers’ compensation exemption when applying for a building permit.
- 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 BP-1 affidavit is for an owner listed as the general contractor on a building permit for a one- to four-family owner-occupied residence, including a condominium. The homeowner checks which qualifying situation applies, provides property and contact details, and signs the affidavit; the form says it serves as an exemption for workers’ compensation and disability benefits coverage once notarized. File it with the government entity issuing the permit.
Who needs it
A homeowner listed as general contractor on a building permit may need this form if the owner-occupied residence and work arrangements meet one of its exemption conditions.
Why it needs a notary
The form states it must be notarized but shows no specific jurat or acknowledgment block; the homeowner signs the affidavit before a notary.
How to get this notarized
- 1
Download the BP-1 Form
Get the Workers’ Compensation Exemption Affidavit and review its eligibility conditions.
- 2
Fill In the Form
Enter the property and homeowner details, select the applicable condition, and leave the signature for the notary session.
- 3
Book an Online Notary
Schedule a remote session with a commissioned online notary.
- 4
Sign on Video
Show identification and sign the affidavit during the online notarization session.
- 5
Submit to the Permit Issuer
File the notarized BP-1 with the government entity issuing the building permit.
Preview the form
The blank PDF straight from Elmira Heights. 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
- Who can use the BP-1 affidavit?
- The form is for owners of one- to four-family owner-occupied residences, including condominiums, who are listed as general contractor on the building permit and meet a listed exemption condition.
- How do I notarize the BP-1 form online?
- Complete the form, then book a session with a commissioned online notary. New York Executive Law §135-c authorizes remote online notarization by New York notaries; sign during the video session.
- Do I need to file this with my building permit application?
- The form says eligible homeowners file BP-1 with the government entity issuing the building permit. Check the permit instructions for how and when to submit it.
- What if I pay workers 40 or more hours per week?
- The form says the homeowner may not file BP-1 in that situation and must instead provide appropriate workers’ compensation coverage proof or have the general contractor provide coverage or exemption proof.
- What if I am unsure whether this form applies?
- Review the exemption conditions on the form and confirm with the city, town or village if unsure. The form also cautions that it cannot waive any party’s workers’ compensation rights or obligations.
Workers’ Compensation Exemption Affidavit in other New York cities
Each city publishes its own version of this form. Pick the city where you’re filing.