The Landmarks Preservation Commission voted 8 to 3 today to approve the plans for a new hospital tower to replace the Edward and Theresa O'Toole Medical Services Building on the west side of Seventh Avenue between 12th and 13th Streets as part of an ambitious expansion plan by St. Vincent's Hospital.

Commissioners Roberta Brandes Gratz, Margery H. Perlmutter and Stephen F. Byrns voted against approval.

Yesterday a lawsuit was filed by several civic organizations and neighbors of the building to overturn the commission's 6 to 4 ruling last October that the approved the "hardship application" to demolish the distinctive structure.

The commission had earlier determined that the building was important architecturally.

The hospital has entered into an agreement with Rudin Management to redevelop its Greenwich Village properties and the controversial plans were substantially revised to meet some community concerns. The present plan calls for a major new hospital building on the site of the O'Toole Building and the preservation of some of the hospital's buildings on the east side of Seventh Avenue and their conversion to residential condominium apartments along with new residential condominium construction that will help finance the hospital's new tower.

The new tower, which has been designed by Pei Cobb Freed, was reduced about 40 feet in height to 286 feet during the lengthy review process and the Rudin's residential plans by FXFowle were significantly altered in number of units and scale.

In a statement released by the hospital after the commission's vote, Bill Rudin said that the development will now move ahead. "The Rudin family is excited to continue its work on the responsible development of the residential components of this plan," he said, adding that "The Rudin family is more committed than ever to our partnership with St. Vincent's, a partnership that will result in a dynamic new residential complex, thousands of jobs for the construction industry, and thousands of New York residents and visitors receiving the healthcare they need and deserve."

Mr. Rudin said that the commission will probably look at his company's residential plans in the project as early as next month.

The low-rise O'Toole building was erected in 1964 as headquarters for the National Maritime Union and its cantilevered design by Albert Ledner incorporated scalloped edges that evoked portholes and had a glass-block base that the law suit maintained "gave it a sense of floating above the ground." The law suit noted that when the building was dedicated "it was singled out by Ada Louise Huxtable, then the architectural critic for The New York Times, for its audacity in breaking with the international style and its effort to reflect the maritime activities that it housed."

The organizations who are the plaintiffs included the Historic Districts Council, the Docomomo New York-Tristate, the Historic Neighborhood Alliance, Landmark West, the Protect the Village Historic District and numerous individuals including Carol Greitzner and three nearby residential buildings.

The O'Toole Building occupies the west blockfront on Seventh Avenue between 12th and 13th Streets and is just to the north of a full triangular block owned by the hospital that is used for trucking facility and used to be the site of the Loew's Sheridan movie theater.