Remodel and addition to an existing radiation oncology department. The addition was a below-grade concrete structure to accommodate a new Linear Accelerator. This included construction of 3 FT thick concrete walls at the perimeter and 6 FT thick walls with 4 inch thick steel plates on both ends of the room for shielding purposes. A 4 inch thick motorized vault door, with a borated polyethylene core, was installed to keep any scattered particles from escaping the exam area. A roof top chiller, dedicated to the linear accelerator, was placed on top of a 3 FT, 8 inch cast-in-place concrete block, located directly above the accelerator. Special precautions had to be taken to prevent disruption in the services of the medical center, which remained in operation during the construction.