Sullivan, NY · Madison County
Homeowner Workers’ Compensation Exemption Affidavit
This 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 lets an eligible homeowner state why they are not required to provide specific proof of workers’ compensation coverage for work covered by a building permit. The form explains that it applies when the owner is doing all the work, hiring no one, or hiring paid workers for fewer than 40 aggregate hours per week while covered by a current homeowners policy. The Town of Sullivan’s form says it must be notarized and is used when applying for a building permit.
Who needs it
A homeowner listed as general contractor on a permit for an owner-occupied one- to four-family residence may need this form if one of its exemption conditions applies.
Why it needs a notary
The form says it must be notarized, but shows no jurat or acknowledgment block; the homeowner signs the affidavit, so ask the issuing office whether a separate certificate is required.
How to get this notarized
- 1
Download the BP-1 Form
Get the Town of Sullivan’s BP-1 homeowner exemption affidavit.
- 2
Complete the Affidavit
Fill in the requested information and select the exemption condition that applies to your project.
- 3
Book an Online Notary
Arrange a remote notarization with a commissioned online notary and ask the Town whether a separate certificate is needed.
- 4
Sign on Video
Follow the notary’s instructions and sign the affidavit during your secure video session.
- 5
Submit to the Town
Submit the notarized BP-1 with your building permit application as directed by the Town of Sullivan.
Preview the form
The blank PDF straight from Sullivan. 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 notarize the BP-1 affidavit online?
- Complete the form, then meet with a commissioned online notary by secure video and sign as directed. The form states that it must be notarized; ask the Town whether it requires a separate notarial certificate.
- Do I need this form for my building permit?
- The form describes its use for eligible homeowners listed as general contractor on a permit for an owner-occupied one- to four-family residence. It provides specific exemption conditions; check with the Town about your project.
- What if I hire workers for 40 or more hours per week?
- The form says the homeowner may not file BP-1 if paid individuals work 40 or more aggregate hours per week. It says to obtain appropriate coverage and proof, or have the general contractor provide proof.
- Can I use the form if I am unsure which exemption applies?
- Review the form’s listed conditions and ask the Town of Sullivan about your building permit. Confirm with the city, town or village if unsure.
- Can I sign this form with a remote online notary?
- New York authorizes remote online notarization by its notaries under Executive Law §135-c, in effect since 2023. The form must be notarized, but ask the Town whether it accepts a remotely notarized submission.
Homeowner 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.