The southwestern slopes drain into the Mettawee River, and thence into the south bay of Lake Champlain.
The route proceeds through the village to its center, where NY 149 forks northeastward onto West Main Street and crosses over the Mettawee River.
Crossing north through the hamlet of Middle Granville, NY 22A parallels the Mettawee River, reaching a junction with the eastern terminus of County Route 23 (CR 23).
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