Claverack, NY · Columbia County
Homeowners Workers’ Compensation Exemption Affidavit
This BP-1 affidavit lets eligible owners of one-to-four-family, owner-occupied residences attest to an exemption from workers’ compensation coverage 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 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. It lets the homeowner attest to qualifying work or hiring conditions when submitting the permit application; the form says it serves as an exemption for workers’ compensation and disability benefits insurance coverage once notarized. It cannot be used to waive any party’s workers’ compensation rights or obligations.
Who needs it
A homeowner listed as the general contractor may need this affidavit when applying for a building permit for an eligible owner-occupied residence and meeting the form’s conditions.
Why it needs a notary
The form carries a “Sworn to before me” jurat; the homeowner must sign and swear to the affidavit before a notary public.
How to get this notarized
- 1
Download the BP-1
Get the Homeowners Waiver form from the Claverack website.
- 2
Complete the Form
Enter the homeowner and property details, and check the exemption statement that applies to your situation.
- 3
Book an Online Notary
Schedule a session with a commissioned online notary through Rush Notary.
- 4
Sign on Video
Show identification, take the oath, and sign the BP-1 during the video session.
- 5
Submit to the City
Submit the notarized form with your building permit application to the government entity issuing the permit.
Preview the form
The blank PDF straight from Claverack. 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 Claverack homeowners exemption affidavit?
- Download the BP-1, complete the applicable information and exemption choice, then sign and swear to it before a notary. Submit the notarized form with your building permit application.
- Do I need to notarize the BP-1 form?
- Yes. The form includes a “Sworn to before me” jurat and a Notary Public block, so the homeowner must swear to the affidavit before a notary.
- Can I sign the BP-1 with a commissioned online notary?
- New York authorizes remote online notarization by a commissioned online notary. You can complete the oath by video, subject to the notary’s identity checks and the receiving office’s requirements.
- What if I expect to hire workers for 40 or more hours per week?
- The form says a homeowner hiring or paying individuals for 40 or more aggregate hours per week may not file the BP-1 affidavit and must arrange appropriate coverage or have the general contractor provide proof. Confirm with the city, town or village if unsure.
Homeowners 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.