Saranac Lake has been fortunate in the number of fine architects who have settled here, often as a result of tuberculosis. William Coulter was the first successful architect to establish a practice in the Adirondacks; when he hired Max Westhoff in 1902, he began a firm that has continued to the present time:

And since William H. Scopes, founder of the prolific firm of Scopes and Feustmann got his start watching William Coulter build the Administration Building at the Trudeau Sanatorium, all of Saranac Lake's firms can be traced back to him.