Built in 1894 to replace Dr. E.L. Trudeau’s original laboratory which was destroyed in a fire, the Saranac Laboratory immediately was on the frontlines of the battle against tuberculosis upon completion. Built to be fireproof, the laboratory was a cutting-edge facility and was the first laboratory in the country that specifically studied tuberculosis. The building was designed by J. Lawrence Aspinwall, and fully funded by a friend of Dr. E.L. Trudeau. The left wing of the building was added in two stages in the 1920s to add more office space and a research library. This addition was funded by the family of John Baxter Black, a wealthy patient who came to Saranac Lake for treatment from intestinal tuberculosis. The laboratory was in operation at this site until 1964, when they moved to a modern facility on the edge of town. The Trudeau Institute is still in operation today. Historic Saranac Lake acquired the property in 1999; it had been modified when it was in service as dorms used by Paul Smith’s College students. In 2007, a massive project was undertaken by Historic Saranac Lake to restore the laboratory back to its original state. Following the completion, the Saranac Laboratory Museum was opened in the building.

Dr. Edward Baldwin’s house was built 1899-1900 by William L. Coulter, replacing an existing house on the site which was moved. Dr. Baldwin came to Trudeau Sanatorium as a patient, and was the director of the Saranac Laboratory for many years following his treatment. In 1916, he started the Trudeau School of Tuberculosis. Later that same year he founded the Edward Livingston Trudeau Foundation. Dr. Baldwin was also instrumental in the building of the Saranac Lake General Hospital.

The Episcopal Church of St. Luke the Beloved Physician, built in 1878, is Saranac Lake's first church. The church was established in 1877, with services held in the Berkeley House by Reverend John Lundy, who began a fund drive to raise money towards a building. The plans were a gift from Richard Mitchell Upjohn (1828-1903), son of the architect of Trinity Church in New York City. The church was built — at today's 136 Main Street — by local contractor R. Eugene Woodruff; construction began in May 1878 and was completed in January 1879. The church was expanded in the 1890s with the addition of a rectory and a parish hall that served as the village library for fifteen years starting in 1892. In 1938-39, the sanctuary was enlarged, and new paneling, altar and reredos, and the windows in the chancel were rearranged creating a side chapel and a new sacristy.

Dr. Edward Livingston Trudeau's first house in Saranac Lake was built in 1884; it contained a laboratory. In 1894, a fire in the laboratory destroyed the building. The current residence was built in 1894 on the same site, a Colonial Revival residence designed by Trudeau's cousin, J. Lawrence Aspinwall. The Saranac Laboratory, also designed by Aspinwall, was built the same year, next door to the residence. The house continued in use as doctors' offices, first for Francis Berger Trudeau and his son Frank, and then as Medical Associates of Saranac Lake, the successor to Frank Trudeau's practice. The practice moved to the Adirondack Medical Center in 2017, and Historic Saranac Lake acquired the building in 2019. Historic Saranac Lake plans to restore the building and open it as a museum that explores the rich history of the Saranac Lake area and Trudeau’s pioneering work in tuberculosis treatment. This project will create a museum campus along with the Saranac Laboratory building.

The Lawrason Brown Office and Residence is a Colonial Revival house which was extensively remodeled in 1907 by Scopes and Feustmann for Dr. Lawrason Brown. Dr. Brown was the resident physician at Trudeau Sanatorium from 1901 to 1912. The living space was upstairs, and Dr. Brown's offices were on the left side of the ground floor. On the second floor was a large library that was used as the living room. There were two maids' rooms on the third, half-floor. The cellar contained Dr. Brown's laboratory and X-ray developing room. Dr. Brown lived in the house until his death on December 26, 1937. His wife stayed on until her death in 1956. The house was converted to four apartments by Evelyn Morgan and John E. Morgan, who bought the house from the Brown estate in 1956.

In 1907, the Saranac Lake Free Library committee started a building fund to construct a new library building in a lot on Main Street was purchased for $2000 from Dr. Lawrason Brown, whose house and office was next door. The new building was designed by Scopes and Feustmann and built, in 1910, by Branch and Callanan; it was one room, with a basement, and had room for 5,500 books. By 1925, the collection had grown to 8,000 volumes, and C.H. Ludington funded an addition as a memorial to his wife. In the late 1960s, a further expansion was funded by Edmond Guggenheim. Further additions were made in 1984 and 2002; by 2007, the collection had grown to 70,000 volumes.

Trudeau Sanatorium had a very successful occupational therapy program, and in 1936, the Saranac Lake Study and Craft Guild was established to provide education, job training, and enrichment for patients in the village, as well as local residents. Courses offered by the Guild were diverse, covering academic subjects like literature and history, as well as more skilled work like glove-making and x-ray technique. In 1962, the property was given to the Saranac Lake Free Library and the Guild house was demolished to make room for an addition to the library. The X-Ray program continued on and eventually became the founding program at North Country Community College.

Built in 1890, the first high school in Saranac Lake was dedicated by President Benjamin Harrison. It once stood on the site of the Hotel Saranac. The school was expanded several times, until a new school was built on Petrova Avenue in 1925 and the students were moved there. In 1968, a new high school was built in Saranac Lake. Petrova currently houses the elementary and middle schools.

Hotel Saranac was built in 1927 by William H. Scopes, of Scopes and Feustmann. Despite having 100 modern guest rooms, a restaurant, a large, ornate ballroom and a Great Hall on the second floor, six hotels and numerous rooming-houses already operated in the village and there was no market for Hotel Saranac. It was never a success financially, and it deeply embarrassed and nearly ruined its promoter. In the 1960s it was sold to Paul Smith’s College and run by the students in the culinary and hospitality departments. The students lived in the Saranac Laboratory building for a time. After a private owner purchased the building in 2006, it was run into the ground. In 2013, the Roedel Partners purchased the property and spent five years and around $30 million completely renovating the hotel. It reopened on January 18, 2018. It has been listed as an Historic Hotel of America by the National Trust for Historic Preservation.

Sometime between 1895 and 1897, Emma T. Harding built a three-story brick building across the street from the hotel at the corner of Main and Academy Streets— the Harding Block. Prior to 1917, the Harding Block had two storefronts. The western one housed the American Express Company, the National Express Company and the Postal Telegraph Cable Company. In the eastern one was the Book Store, Harding & Gray, New York Papers. Ownership of the Harding Block passed from Emma T. Harding to E. J. Kennedy in March, 1918. Kennedy hired the firm of Scopes and Feustmann to design a new storefront for the building, knocked out the interior ground floor divisions, and opened what was for ladies the equivalent of T. F. Finnigan's or C. J. Carey's. The E. J. Kennedy's store remained in the Kennedy family until December, 1973. In March 1974, the was sold to Kastern Inc. which transferred it to the ownership of its president, Hans Katzenstein, in August of that year. It was then the site of Katzenstein's Town and Country Shop and of the Parnell Shoe Salon. It is now the location of McSweeney Orthodontics (2020).

The Pontiac Theatre had, at one time, the largest screen in central New York and a twelve thousand dollar orchestral organ. Built in 1917, the theatre was designed by Scopes and Feustmann. In 1926, the owners of the theatre sold it to the Schine theatre chain; after the chain was dismantled, the theatre was purchased by the Pontiac Entertainment Corp. Al Jolson once performed a solo at the Pontiac Theatre for three hours for a benefit. The world premiere showing of the 1954 film, The Silver Chalice, was held at the Pontiac. This was Paul Newman's feature film debut, and the premiere was hosted by television personality Art Linkletter. Saranac Lake won the movie premiere for having sold the most Christmas seals that year. Several of the stars, including Virginia Mayo, visited the village and participated in the Winter Carnival parade. Newman did not attend. The theatre burned to the ground on December 19, 1978. The week that it burned, the movie "Foul Play" was showing; the next week's film was to have been "Up In Smoke".

Named for Irish philosopher Bishop George Berkeley, the Berkeley House was built in 1875 by Charles F. Gray for the accommodation of tuberculosis patients who were then beginning to come to Saranac Lake for their health. It originally had a capacity for only fifteen or twenty guests. Eugene Woodruff succeeded Gray as proprietor, and in 1882 a Mr. Streeter and his partner Mr. Dennison took it over, enlarged it, and ran it successfully for a number of years. U. S. President Benjamin Harrison stayed at the Berkeley in September of 1890 when he was in town to dedicate the new Saranac Lake High School. In 1913 it was bought by Walter Sagendorf, who owned it until 1940. The hotel received significant damage in a fire on January 1, 1925, but it was rebuilt and reopened. The hotel was bought in 1978 by 21 year old John McClain who refurbished the hotel for use by those attending the 1980 Winter Olympics. It burned to the ground, January 10, 1981. It became Berkeley Square park.

Peddler William C. Leonard, upon having success with his first department store, constructed the building that would be Saranac Lake's only full size department store on the lot at 83 Main St., between his first store and the Coulter Block. Leonard’s Department Store offered a wide variety of merchandise at reasonable prices. This, along with a pneumatic tube delivery system that connected the store's four floors of departments to a central cashier made the store an attractive and integral part of Saranac Lake. The store remained in the Leonard family until Mildred Leonard Baker sold it to Mark David Associates, Inc. in September, 1965. However, it had been leased to other companies since the mid-1940s. In October, 1973, National Army Stores Corporation chain obtained the property. In 1982, the owners of the buildings restored the second and third story facade to its original (as nearly as possible) condition. The building is currently the location of Surgical Eye Care (2020).

Built 1899-1901 by William L. Coulter, the two three-story buildings at 76-82 Main Street would become known as the Coulter Block. Two of the earliest tenants were Donaldson’s Adirondack National Bank, and C.J. Carey clothing store — T.F. Finnegan was a partner in this store before beginning his own. Photographer William Kollecker had his shop here, and his store became a staple in Saranac Lake life. The Kollecker Kodak and Gift Shop was a favorite of local children, as Kollecker kept a full series of movies of circus parades and other entertaining sights to show to them. He set up elaborate window displays, especially at Christmastime. He set up the first mechanically rotating Christmas tree in the village. After Kollecker’s death, his apartment & store were gutted, and his belongings were thrown away as he had no will. Luckily, some of his work had already been donated to the Saranac Lake Free Library, and a quick-witted passerby intervened and managed to have some of the materials delivered to his home rather than the dump. These photographs and films can be seen in the Adirondack Room at the Library today. In the 1970’s, the buildings housed "Bud" Hunt's Insurance and real estate office, the Saranac Lake Jewelers, the offices of the American Red Cross and the Plattsburgh Press Republican, and several apartments. Currently, Liz Company, State of Mind, and Savvy Boutique operate on the Coulter Block (2020).

In 1891, Dr. Frank E. Kendall built and opened the Kendall Pharmacy on 82 (now 81) Main street. This was the second pharmacy in Saranac Lake and it would remain a pharmacy until 1960, when the Kendall Building was sold to the Wilson Clothing Company. Wilson's widened and "modernized" the front of the building, and linked the rears of the surrounding buildings. In 2017, Blue Line Sporting Goods rehabilitated the facade to be more in keeping with the historic character of the downtown district.

Roberts Block was built in 1900 by William F. Roberts, real estate dealer. In the early years of the building, A. Bruzza Confectionary operated in the building. This shop was fondly remembered by older SL residents for its marble tables and counters, its baskets of fruit, its ice cream and candy, and its stalks of bananas hanging in the windows. In 1923, the building was purchased by T.F. Finnigan and opened as a clothing store. The building was owned by Finnegan’s descendants until 2018 when it was sold. The store remains the T.F. Finnigan clothing store (2020).

Built by W. S. Fowler in 1900, the building at 76 Main Street was the first structure in Saranac Lake designed by architect William H. Scopes. By 1909, W. Smith and Jessie Fowler sold the Fowler Block to William J. and Matthew M. Munn, who opened the Munn Brothers' Grocery, a very successful store. When the building was bought by John S. Ridenour, publisher of the Adirondack Daily Enterprise, in 1926 an extension was added to the building. Designed by William G. Distin, Sr., it was built to withstand the weight and vibrations of hot-type newspaper printing equipment. Ridenour was a forward-thinking publisher and tested many cutting-edge newspaper technologies, including the Wood Bee-Line Press. It had a capacity of 12,000 newspapers per hour, but its operators could not keep up with its output and it was only ever run at half speed. In 1965 the building was sold to Tubby and Loeb's Adirondack Publishing Company. After the 1973 purchase of the building by William Doolittle, all of the printing equipment was scrapped. In the years since, many businesses have called the Fowler Block home, with Origin Coffee Co., Human Power Planet Earth bike shop currently operating in the building (2020).

Constructed in 1906, the Adirondack National Bank was once a beautiful stone building built on the site of guide Reuben Reynolds’ house. Sadly, this building is a reminder of what can happen when history isn’t protected. This building is a reminder of the importance of historic preservation, and inspired history-minded locals to start what would become Historic Saranac Lake. The 1963 “modernization” of the building left one of the most beautiful facades on Main Street as a brick wall, and destroyed the interior. Previously occupied by Key Bank, the building is now vacant (2020).

In June, 1907, the Haase Block was constructed at 60 Main Street by Scopes and Feustmann. Owned by 35 year old wealthy Episcopal clergyman William Haase, the earliest tenants of the Haase Block were the Saranac Lake National Bank, the Denny jewelry store, and architects Scopes and Feustmann . Marie Haase, William Haase’s wife, created the Tent Theatre behind the Hasse block. This is where actress Rosalind Russell got her start in 1929 at age 22. The building held the architect firm of Scopes and Feustmann (which evolved into Wareham and DeLair) until the 1980s, when the Adirondack Bank became the sole occupant of Haase Block.

After contracting tuberculosis in 1895, Alfred Donaldson came to Saranac Lake. Coming from a family of wealthy bankers, he founded the Adirondack Bank in 1897. He also erected a building known as the Donaldson Block in 1901, and the first occupants of its two storefronts were Western Union Telegraph and Cable Co. and George Baldwin, photographer. In 1908, William Distin bought the property from Donaldson. The Donaldson block was once again sold in 1922, and by 1937, the Saranac Lake National Bank possessed the building. Less than a year after acquiring the Donaldson Block, the Saranac Lake National Bank went bankrupt trying to finance the new highway to Tupper Lake; and the Federal Deposit Insurance Corporation took custody of the building in October, 1938. In 1943, the building was sold to Rex A. Holmes, a lawyer, who owned the building until the 1980s. 63 Main Street is now the location of China Jade restaurant and Belleville and Associates insurance.

Built by Milo Miller prior to 1879, the Post Office Pharmacy building was originally constructed to house the Franklin County Library. Robert Louis Stevenson borrowed books from this library in the winter of 1887-88. Around 1910, the building became a commercial business building, first housing a shop which had a large sign on the building that read “Adirondack Beef Company, Meats, Fish, Fruits & Vegetables” (& Oysters). In 1917, Gibney’s Market, a very high-end meat market which specialized in wild meats-pheasant, squab, and venison was opened. During the depression, Gibney’s Market went bankrupt, and the Post Office Pharmacy opened in 1936. It was the last of Saranac Lake's nine original pharmacies, called the Post Office Pharmacy because it moved from a building that contained or was next to the first Post Office (where Downhill Grill is now). This building has never been a post office. The Post Office Pharmacy closed in December 2019.

Built sometime between 1880 and 1890, the building at 57 Main Street (currently Ayres Realty and Insurance) is the largest of Milo Miller's Second Empire buildings. H. H. Tousley operated a grocery in the building c. 1910, and following Tousley was William Mullen with his Saranac Supply. Saranac Supply was located on Main Street until about 1921, after which the Mullen store moved to the Colonial Theater Building on Broadway. During the period of America's involvement in World War I, there was a barrel behind the Supply. Anyone buying peaches was asked to put the pits in the barrel. Periodically, the pits were taken away to a processing plant where they were ground to be used in the filters of gas masks. Between 1922 and 1923, the ground floor was made into two storefronts from one, and had the present facade erected. The first occupant of the northern storefront was the Margaret Kelly Dress Shop. In 1925 it became Irving Altman's ladies' apparel store. Altman remained a tenant there until 1932 when he moved to his own building. For part of this period, Flora Pruess operated a children’s-wear store. In the 1950s, flyweight Golden Gloves champion known to all as "Little Joe", opened a tavern. Little Joe's rapidly became the most popular Saranac Lake meeting and drinking place of the 1950s and early 1960s.

Constructed after 1925, the building that is currently the Blue Moon Cafe operated as a shop that sold books, school supplies, "tasteful" souvenirs, art supplies, and fishing equipment in the 1940s. In December, 1955, "The Bookstore" was sold from Earl Gray to Donald R. Moreau who, five years later, sold the business to William L. Harvey, Jr. but retained ownership of the building until 1960. Yum Yum Tree Gift Shop and Tandel Office Supplies operated in the building until the 1980s. The Blue Moon Cafe opened in the 1990s.

Hogan Block was fully constructed between the 1890s and 1908. The first business to open on the property was Hogan’s Pharmacy, which was owned and operated by John R. Hogan from the late 1800s into the early 1900s. The Hogan Block was also the home of Sam Edelberg's Tailor Shop (later Edelberg's Fur Store) which was opened around 1907. In the 1920s, British immigrant Charlie Green opened Green’s Market, which would be a staple of Saranac Lake life until it was closed shortly before his death in the 1980’s. Hogan Block currently houses the Adirondack Artists’ Guild.

Constructed around 1895, the building that is now 'The Waterhole' has housed many different businesses over the years. The building was first utilized as a Blacksmithing shop, operating as such until 1918 when Washer’s Tire Vulcanizing shop took its place. In the following years, ownership shifted many times; Washington Market (1925), Lawrence's Livery, Ryan's Livery, and Mike & Sandy's Lunch Room (at least 1948 to 1968). In 1970, Waterhole was opened- named for a 1967 comedy western, Waterhole #3 starring James Coburn.

Built in 1867, this building is the oldest remaining commercial building in Saranac Lake. Until 1890, this three story, wood-frame building was the home of Miller's Store, a general merchandise store. For the next 43 years it was the location of A. Goldsmith and Son Drygoods. Charles H. Goldsmith took over the business from his father and then bought the building from the Milo B. Miller Estate in December, 1921. It was theirs until June, 1945. Since then, the Miller Store building has housed a variety of businesses and has had six owners, including E.L. Finnegan's Shoes (1940s); Western Auto (1960s - 1970s); Journey's End; Snuffy's Pub and Owl's Nest Pizza (1990- present).

In 1924, the Milo Miller Estates constructed the Tousley Building. The first use of the building was as Vern Carr's parking garage and Dodge sales agency. There is a freight elevator in the building that has a capacity of 7425 pounds. Made by the Warsaw Elevator Co. of Warsaw, N.Y., it is large enough to carry two automobiles side by side. Until the early 1950s, the old State Conservation Department's District offices occupied the second floor office space. Of the two storefronts, the southern one has held a liquor store since right after prohibition. This was owned and operated by Henry Tousley's son, Frederick, until his death c. 1954, and continued under the name "Tousley Liquors”. In about 1940, the Miller Estate opened the Adirondack Storage Vaults in the vast second floor space behind the offices. This was a refrigerated cold-storage vault for furs. Until around 1960, when Lincoln opened their Iron Mountain facility south of Hudson, New York, the vaults of the Tousley Building held microfilmed copies of all the valuable records of most of the major oil companies in the United States, the New York Stock Exchange and many of the largest stock brokerage firms, as well as many of the nation's big banks and insurance companies, not to mention shipping companies, mining companies and numerous corporations holding large Pentagon contracts. To this day, the building is used for storage and contains a liquor store.

The style of stonework in the foundation seems to indicate that the Rice Furniture building was built around or before 1900. The decade 1900 to 1910 in Saranac Lake saw the evolution of more "finished" foundation work with more uniformity of stone size and type and also the introduction of poured concrete. Walton and Tousley Hardware operated a store in the building until July, 1948, when the corporation liquidated and its real estate assets were purchased by G. Carver Rice, Inc. The building is actually two structures, the rear segment having been added probably during the early years of the Walton and Tousley ownership. Both buildings are three stories, but the addition was built on lower ground, and the roof levels of the two did not match. In 1960, a fire ravaged Rice's. As part of the repair process following the blaze, the top story of the front building was removed and its facade redone in a "contemporary" 1960s style.

In 1882, Harrietstown erected a large wooden structure that would become known as Old Town Hall on a lot of land owned by the grandson of Pliny Miller. In July of 1926, a deadly fire engulfed the building, leading to the death of one man and many injuries. The fire also destroyed hundreds of historical documents, including the Adirondack Daily Enterprise's full newspaper archive. Two years later, the new (fireproof) town hall was constructed on the same site, designed by William H. Scopes and Maurice Feustmann. The tower on the building is a copy of Philadelphia's Independence Hall, featuring a traffic light on the top. This is rumored to have been used to signal emergency services.

The Empire Hotel at 28 Main Street was built before 1895 as the St. Nicholas Hotel. Michael J. Brennan was the proprietor. In 1898 the name was changed to the Dewey House, owned by William Dewey and by 1899 an ad gave A. M. Dewey as proprietor. In 1908, it was called the Empire Hotel, Daniel A. Walsh, proprietor. There was an ice house and stable/livery behind it. After 1903 it was managed by George Downing and John Crowley. It had 29 rooms, and its dining room could seat 40; it was just south of the old Harrietstown Town Hall and was nearly lost in the 1926 fire that consumed the town hall. It was torn down to make way for the enlarged Town Hall in 1927.

Built between 1899 and 1903, Currier Block has been utilized in many different ways since. Currier Block was used as a cure cottage during the years that Saranac Lake was a health resort for those "curing" from tuberculosis, and operated under many different names, including Dawson Cottage (1911), Sherlock Cottage (1911), Tower Cottage (1928), and Johnston Cottage (1930), and Currier's Apartments in 1950. During this time, it was also where the Currier Press was located, which was operated and owned by Al Currier. The building is currently a Little Italy restaurant.

In 1860, Orlando Blood opened Blood's Hotel in Saranac Lake. Blood first leased it from John J. Miller, who had built it. He bought it along with eighty acres in 1865 for $2,115. In 1886, lumberjack and guide Wallace Murray purchased the hotel and changed the name to the Riverside Inn. The Riverside Inn contained 61 bedrooms, exclusive of those occupied by family and servants. Mark Twain occasionally sat on the shaded veranda. The dining room could seat 130, a large accommodation for the time. As the tide of TB patients arriving in the village grew, the hotel was used to accommodate patients when they first came to the village. The Riverside Inn was torn down in the 1930s after the Great Depression greatly reduced the number of tourists.

Paul Smith's Electric Light and Power and Railroad Company Complex (now Saranac Lake Police Headquarters) was originally the site of a sawmill built by Captain Pliny Miller in 1827. In 1895, the Saranac Lake Electric Company bought the property and constructed a power plant. In 1907, Paul Smith bought the Saranac Lake company for $125,000. After Smith's death in 1912, his son, Phelps Smith took over, and in 1927, constructed the present office building directly above the old flume. After Phelps Smith died in 1937, he left the bulk of his estate to establish Paul Smith's College. The College owned and operated the power company until 1941 or 1942, when the equipment was scrapped to aid the war effort. The building was used as an office space until 1986, when the Village of Saranac Lake acquired the property. The Saranac Lake Police Department currently operates from the building (2020).