Bayville, NY · Nassau County
Workers’ Compensation Exemption Affidavit
This BP-1 affidavit lets eligible owners of one- to four-family, owner-occupied residences document 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 a homeowner listed as the general contractor on a building permit for a one- to four-family, owner-occupied residence, including a condominium. It states why the homeowner qualifies for an exemption, based on who performs or is paid to perform the work and, in some cases, active homeowners insurance and weekly work hours. The homeowner files the completed, notarized form with the government entity issuing the permit; the form cannot waive any party’s workers’ compensation rights or obligations.
Who needs it
A homeowner listed as the general contractor for a one- to four-family, owner-occupied residence may need this affidavit when applying for a building permit and qualifying for the stated exemption.
How to get this notarized
- 1
Download the BP-1 Form
Download the Workers’ Compensation Exemption Affidavit for your building permit application.
- 2
Complete the Affidavit
Fill in the requested information and select the exemption condition that applies. Leave the signature for your notary session.
- 3
Book an Online Notary
Schedule a remote session with a commissioned online notary.
- 4
Sign on Video
Show identification, then sign and swear to the affidavit during the video appointment.
- 5
Submit to the City
Submit the notarized BP-1 to the government entity issuing your building permit.
Preview the form
The blank PDF straight from Bayville. 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 get the BP-1 affidavit notarized online?
- Complete the form, then book a session with a commissioned online notary. Sign and swear to the affidavit during the video appointment, and submit the notarized form with your building permit application.
- Do I need to qualify for the exemption before filing BP-1?
- Yes. The form is for qualifying owners of one- to four-family, owner-occupied residences who meet one of its stated conditions. It says homeowners hiring or paying people for 40 or more hours per week cannot file this affidavit.
- Can a commissioned online notary notarize this New York form?
- New York authorizes remote online notarization by its own notaries under Executive Law §135-c, effective in 2023. A commissioned online notary can conduct the notarization remotely if the notary and signer meet the applicable requirements.
- Where do I submit the notarized affidavit?
- The form says to provide it to the government entity issuing the building permit. For Bayville filing procedures or questions about your application, confirm with the city, town or village if unsure.
Workers’ Compensation Exemption Affidavit in other Nassau County cities
Each city publishes its own version of this form. Pick the city where you’re filing.