Fayetteville, NY · Onondaga County
Homeowner Workers’ Compensation Exemption Affidavit
This BP-1 affidavit lets an eligible owner of a one- to four-family owner-occupied residence 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 form is for homeowners listed as the general contractor on a building permit who meet one of its stated exemption conditions: doing the work themselves, not hiring or paying workers, or paying workers fewer than 40 total hours per week with qualifying homeowners insurance. The homeowner swears to the information and signs before a notary. The form says it cannot waive any party’s workers’ compensation rights or obligations.
Who needs it
A homeowner listed as general contractor on a permit for an owner-occupied residence of one to four families may file this affidavit if one of its exemption conditions applies.
How to get this notarized
- 1
Download the BP-1 Form
Get the homeowner workers’ compensation exemption affidavit and the building permit materials for your property.
- 2
Complete the Affidavit
Enter the homeowner and property information and select the exemption condition that applies.
- 3
Book an Online Notary
Schedule a remote session with a commissioned online notary.
- 4
Take the Oath and Sign
Show identification, take the oath, and sign the form during the online notarization.
- 5
Submit to the City
Submit the notarized BP-1 with your Fayetteville building permit application.
Preview the form
The blank PDF straight from Fayetteville. 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 BP-1 affidavit?
- Check the exemption condition that applies, complete the homeowner and property details, then take the oath and sign before a notary. Submit the notarized form with your building permit application.
- Do I need a notary for this form?
- Yes. The form includes a “Sworn to before me” jurat, so the homeowner must take an oath and sign before a notary.
- Can I notarize the BP-1 form online?
- New York authorizes remote online notarization by a commissioned online notary. Confirm with the city, town or village if unsure whether it will accept a remotely notarized BP-1.
- When can a homeowner use this exemption affidavit?
- The form lists qualifying situations for owners of one- to four-family owner-occupied homes, including doing all the work themselves or meeting the stated hiring, hours, and homeowners insurance conditions.
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.