From South Berwick, Route 4 runs in a northeasterly direction through the town of North Berwick, bypassing the center of the city of Sanford to the east, and coming to an intersection with U.S. Route 202 in Alfred.
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By 1937, most of the routes that are cosigned with it had been designated, most notably U.S. Route 202.
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Although they are not directly connected to one another, they are linked by their parent highway, Maine State Route 4, as well as U.S. Route 202, which runs concurrently with Route 4 during this stretch.
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However, signage indicates the end of the route to be at the intersection of Minot Avenue and Washington Street, which carries U.S. Route 202, Route 4, and Route 100.
The only change that has ever occurred was the overlapping of U.S. Route 202 and SR 4 over SR 100, where SR 122 has always had its eastern terminus.
The route follows a roughly southeast-to-northwest trajectory, passing through the center of town and crossing over US 202 and SR 4.
a new 1.6-mile (2.6 km) bypass, State Route 26A, was completed and put into service to alleviate congestion in the center of Gray Village where U.S. Route 202, SR 4, SR 26, SR 100, and SR 115 intersect.