Fillable Form 2.: PERMIT. SATISFACTORY IN FOR PROVIDED AS (City of Binghamton)

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Form 2.: PERMIT. SATISFACTORY IN FOR PROVIDED AS (City of Binghamton)

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•
LAWS
OF
NEW
YORK,
1998
CHAPTER
439
The
general
municipal
Jaw
is
amended
by
adding
a
new
section
125
to
read
as
follows:
125.
ISSUANCE
OF
BUILDING
PERMITS.
NO
CITY,
TOWN
OR
VILLAGE
SHALL
ISSUE
A
BUILDING
PERMIT
WITHOUT
OBTAINING
FROM THE
PERMIT
APPLICANT
EITHER:
1.
PROOF
DULY
SUBSCRIBED
THAT
WORKERS’
COMPENSATION
INSURANCE
AND
DISABILITY
BENEFITS
COVERAGE
ISSUED
BY
AN
INSURANCE
CARRIER IN
A
FORM
SATISFACTORY
TO THE
CHAIR
OF
THE
WORKERS’
COMPENSATION
BOARD
AS
PROVIDED
FOR
IN
SECTION
FIFTY-SEVEN
OF
THE
WORKERS’ COMPENSATION
LAW
IS
EFFECTIVE;
OR
2.
AN
AFFIDAVIT
THAT
SUCH
PERMIT
APPLICANT
HAS
NOT
ENGAGED
AN
EMPLOYER
OR
ANY
EMPLOYEES
AS
THOSE TERMS
ARE
DEFINED
IN
SECTION
TWO
OF
THE WORKERS’ COMPENSATION
LAW
TO
PERFORM
WORK RELATING
TO
SUCH
BUILDING
PERMIT.
Implementing
Section
125
of
the
General
Municipal
Law
1.
General
Contractors
--
Business
Owners
and
Certain
Homeowners
For
businesses
and
certain
homeowners
listed
as
the
general
contractors
on
building
permits, proof
that they
are
in
compliance
with
Section
57
of
the
Workers’
Compensation
Law
(WCL)
is
ONE
of
the
following
forms
that
indicate
that
they
are:
•
insured
(C-105.2
orU-26.3),
•
self-insured (SI-12), or
+
are
exempt
(CE-200),
under
the
mandatory
coverage
provisions
of
the
WCL.
Any
residence
that
is
not
a
1,2,3
or
4
Family,
Owner-occupied
Residence
is
considered
a
business
(income
or
potential
income
property)
and
must
prove compliance
by
filing
one
of
the
above
forms.
2.
Owner-occupied
Residences
For
homeowners
of
a
1,
2,3
or
4
Family,
Owner-occupied
Residence,
proof
of
their
exemption
from
the
mandatory
coverage
provisions
of
the
Workers’
Compensation
Law
when
applying
for
a
building
permit
is
to
file
form
BP-l.
•
Form
BP-lshall
be
filed
if
the
homeowner
of
a
1,2,3
or
4
Family,
Owaer-occupied
Residence
is
listed asthe
general
contractor
on
the
building
permit,
and
the
homeowner:
O
is
performing
all
the
work
for
which
the
building
permit
was
issued
himlherself,
O
is
not
hiring,
paying
or
compensating in
any
way,
the
individual(s)
that
is(are)
performing
all
the
work
for
which
the
building
permit
was
issued or
helping
the
homeowner
perform
such
work,
or
O
has
a
homeowner’s
insurance
policy
that
is
currently
in
effect
and
covers
the
property
for which
the
building
permit
was
issued
AND
the
homeowner
is
hiring or
paying
individuals
a
total
of
less
than
40
hours
per
week
(aggregate
hours
for
all
paid
individuals
on
thejobsite)
for
the
work
for which
the
building
pennit
was
issued.
•
If
the
homeowner
of
a
1,
2,
3
or
4
Family,
Owner-occnpied
Residence
is
hiring or
paying
individuals
a
total
of
40
hours
or
MORE
in
any
week
(aggregate
hours
for
all
paid
individuals
on
the
jobsite)
for
the
work for
which
the
building
permit
was
issued,
then the
homeowner
may
not
file
the
“Affidavit
of
Exemption”
form,
BP-
1(11/04),
but
shall
either:
O
acquire
appropriate
workers’
compensation
coverage
and
provide
appropriate
proof
of
that
coverage
on
forms
approved
by
the
Chair
of
the
NYS
Workers’
Compensation Board
to the
government
entity issuing
the
building
permit
(the
C-lOS
.2
or U-26.3 form),
OR
O
have
the
general
contractor,
(performing
the
work
on
the
1,
2,
3
or
4
family,
owner-occupied
residence
(including
condominiums) listed
on
the
building
permit) provide
appropriate
proof
of
workers’
compei~sation
coverage,
or
proof
of
exemption
from
that
coverage
on
forms
approved
by
the
Chair
of
the
NYS
Workers’
Compensation
Board
to
the
government
entity
issuing
the
building
permit.
BP-1
(12/0
8)
Reverse
www.web.state.ny.us
Affidavit
of
Exemption to
Show
Specific
Proof
of
Workers’
Compensation
Insurance
Coverage
for
a
1,
2,
3
or
4
Family,
Owner-occupied
Residence
**Thjs
form
cannot
be
used
to
waive
the
workers’
compensation
rights
or
obligations
of
any
party.
**
Under
penalty
of perjury,
I
certi~’
that
I
am
the
owner
of
the
1,
2,
3
or
4
family,
owner-occupied
residence
(including
condominiums)
listed
on
the
building
permit
that
I
am
applying
for,
and
I
am
not
required
to show
specific
proof
of
workers’
compensation
insurance
coverage
for
such
residence
because
(please
check
the
appropriate
box):
D
I
am
performing
all
the
work
for
which
the
building
permit
was
issued.
LI
I
am
not
hiring,
paying
or
compensating
in anyway,
the
individual(s)
that
is(are)
performing all
the
work
for
which
the
building
permit
was issued
or
helping
me
perform
such
work.
El
I
have
a
homeowners
insurance
policy
that
is
currently
in
effect
and
covers the
property
listed
on
the
attached
building
permit
AND
am
hiring
or
paying
individuals
a
total
of
less
than
40
hours
per
week
(aggregate
hours
for all
paid
individuals
on
the
jobsite)
for
which
the
building
permit
was issued.
I
also
agree to
either:
+
acquire appropriate
workers’
compensation
coverage
and
provide
appropriate
proof
of
that coverage
on
forms
approved
by
the
Chair
of
the
NYS
Workers’
Compensation
Board
to
the
government
entity
issuing
the
building
permit
if
I
need
to
hire
or
pay
individuals
a
total
of
40
hours
or
more
per
week
(aggregate hours
for
all
paid
individuals
on
thej
obsite)
for work
indicated
on
the
building
permit,
or
if
appropriate,
file
a
CE-
200
exemption
form;
OR
+
have
the
general
contractor,
performing
the
work
on
the
1,
2,
3
or
4
family,
owner-occupied
residence
(including
condominiums)
listed
on
the
building
permit
that
Jam
applying
for,
provide
appropriate
proof
of
workers’
compensation
coverage
or
proof
of
exemption
from
that
coverage
on
forms
approved
by
the
Chair
of
the
NYS
Workers’
Compensation
Board
to
the
government
entity
issuing
die
building
permit
if
the
project
takes
a
total
of
40
hours
ormore
perweek
(aggregate hours
for all
paid
individuals
on
the
jobsite)
for
work
indicated
on
the
building
permit.
(Signature
of
Homeowner)
(Date
Signed)
________________________________
Home
Telephone
Number
__________________
(Homeowner’s
Name
Printed)
________________________________________________
Sworn
to
before
me
this
__________
day
of
Property
Address
that
requires
the
building
permit:
_________________
___________
______
+
(County
Clerk
or
Notary
Public)
Once
notarized,
this BP-1
form
serves
as
an
exemption
for
both
workers’
compensation
and
disability
benefits
insurance
coverage.
BP-l
(12/08)
NY-WCB
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Completed 15 January 2021

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