Expect a camera inspection first. The plumber runs a camera through the cleanout to find roots, cracks, sags, or a collapse, and records how far from the house it is. That footage tells you whether the trouble is on your side, near the town main, or at the septic tank.
Repairs range from cutting roots and patching one joint to replacing the whole line, either by trenching or with trenchless methods where the pipe and soil allow. Ask whether work at the town main calls for a drainlayer on the town's list; plumbing changes inside the house go through Building & Inspections, which, as of its archived February 2026 page, takes permits online.
On a septic property, the repair may lead to a septic inspection or Board of Health review, especially if the tank or field turns out to be part of the problem.