Fifteen Cape Cod towns and eight on the South Shore, each with its own rules and money

Barnstable County: AquiFund, 31 designated watersheds and sewer phases

The 15 Cape towns share three things a South Shore town does not have. The Cape Cod AquiFund lends county-wide at 0% to 5% for up to 20 years, repaid on the tax bill. The July 2023 Title 5 amendments designated 31 Cape watersheds as nitrogen sensitive, and every town with one filed a notice or application by July 7, 2025, so no state upgrade clock is running, though local rules in Falmouth, Mashpee and Eastham add their own triggers and Truro is drafting them. And the sewer map matters: Barnstable, Chatham, Orleans, Dennis, Yarmouth and Provincetown are all extending pipe, and East Harwich already drains to Chatham, which can turn a replacement into a connection.

The town pages: Barnstable, Bourne, Brewster, Chatham, Dennis, Eastham, Falmouth, Harwich, Mashpee, Orleans, Provincetown, Sandwich, Truro, Wellfleet and Yarmouth. Each names the health office and its fees where published, the local regulation and its date, the watershed filing, and the sewer phase if there is one. The nitrogen rules guide covers the 2023 amendments across all of them.

Plymouth County: the state credit, town loans and stricter local codes

Across the canal there is no county loan, no nitrogen designation and no I/A mandate. What replaces them is the state tax credit, 60% of up to $30,000 for a failed system at a principal residence, MassHousing’s $25,000 septic repair loan, and town betterment programs where they exist: Plymouth and Middleborough publish 5% loans, Kingston and Carver list programs whose terms are not online. Local codes are often stricter than Title 5 here. Pembroke designs at 150 gallons per bedroom and requires concrete tanks, Marshfield keeps leach fields 200 feet from wells and orders sewer connection within a year, Duxbury inspects for any addition over 50 square feet, and Wareham, Duxbury and Pembroke fail a cesspool at sale.

The town pages: Plymouth, Wareham, Kingston, Carver, Duxbury, Marshfield, Pembroke and Middleborough. The AquiFund guide explains the county line in detail.

What stays the same on both sides

The inspection rule does not move. A MassDEP-approved System Inspector, a report filed within 30 days, two years of validity, and two years to upgrade after a fail apply in every town, as the Title 5 guide explains. So does the work: a full replacement, a Title 5 inspection or a sewer connection is permitted by the same board of health process whichever county you are in. The town page tells you what the local installer license is called there, so you can ask to see it.