By Glenn Collins

The Landmarks Preservation Commission on Tuesday sent St. Vincent’s Hospital Manhattan, which had pushed for a $1.6 billion development proposal within the Greenwich Village Historic District, back to the drawing board.

The plan would have demolished nine existing buildings to permit the construction of a 329-foot-tall hospital and a 265-foot-tall luxury condominium in conjunction with the Rudin Management Company. All of the 10 commissioners present spoke at a public hearing and all opposed it.

Although there was no vote, the commissioners’ public comments served as a rejection of the hospital’s proposal.

Some of the commissioners spoke favorably about parts of the plan, but none supported demolishing nine buildings so that two massive towers could be constructed.

“We must proceed extremely cautiously,” said Robert B. Tierney, the commission’s chairman. “The idea of any demolition in a historic district is an enormous step. It is time for everyone to be taking a deep breath and doing some rethinking.”

Preservationists were jubilant after the two-hour hearing.

“This is a powerful, stinging rebuke to the St. Vincent’s plan,” said Andrew Berman, executive director of the Greenwich Village Society for Historic Preservation. “And it’s a forceful defense of the whole meaning of landmarks preservation.”

Henry J. Amoroso, president of St. Vincent Catholic Medical Centers, the entity that includes the hospital, said it would now, as a nonprofit organization, file an application asking for “hardship” status.

“We will return as soon as possible to the landmarks commission with a hardship application for the demolition of the O’Toole Building,” he said in a statement.

Mr. Amoroso referred to the porthole-pierced 1964 structure between West 12th and West 13th Streets, once derided in the neighborhood as the “overbite building” for its serrated setbacks. Originally built for the National Maritime Union of America, it is now admired by many preservationists for its unusual nautical motif.

The developer William C. Rudin, who attended the hearing, said in a statement afterward that he hoped to “identify a viable alternative that would address the concerns of the commission and the community.”

Under the plan proposed by St. Vincent’s, the hospital would have moved from its current buildings, on the east side of Seventh Avenue between 11th and 12th Streets, to the West Side of Seventh Avenue between 12th and 13th Streets, into a new $800 million, 329-foot-tall building on the site of the O’Toole Building, which would have been razed.

In a complex deal, eight other hospital buildings in the historic district would have been sold to the Rudin Management Company for $301 million. St. Vincent’s would have used that money to reduce its debt and pay for part of the new hospital.

The Rudin Company would then have demolished the old hospital buildings and constructed a separate $800 million residential complex that would have included a 265-foot-high luxury condominium tower on Seventh Avenue, and new town houses and a midsize residential building on 11th and 12th Streets.

Although some neighborhood residents expressed support for the hospital, many who spoke at previous hearings said that the large residential and medical towers would blight their neighborhood. Preservationists feared that the approval by the landmarks commission would undermine landmark-district protection throughout the city.

Hospital officials testified, though, that a new building was essential to maintain modern health care for more than a million people who live in, work in or visit the area St. Vincent’s serves on the West Side.

Most of the commissioners rejected the height and bulk of both the hospital building and the condominium tower, and found value in many of the existing St. Vincent’s buildings. “The loss of all these landmarks would remove layers of history that cannot be replaced,” said one commissioner, Roberta Brandes Gratz, adding that approval of the plan would threaten other historic districts because it would be “a clear invitation for other institutions.”

Mr. Amoroso said the hospital was ready to amend its landmarks application “in the event the Rudin family decides to modify its plans to develop the current hospital campus for residential use.”

A new proposal could preserve some or all of the buildings across Seventh Avenue from the O’Toole site. The modifications, however, would have to be submitted for public hearings and commentary at Community Board 2, and then would have to undergo another round of hearings at the landmarks commission. The proposal would then need approval from the City Planning Commission and the City Council.

As for the hardship application, “the reality,” Mr. Amoroso said, “is that the O’Toole site is the only location where we can build a fully efficient, state-of-the-art green hospital to serve the people of New York.”

A hardship filing would require the hospital to open its books to the commission. St. Vincent’s, the city’s only remaining Roman Catholic hospital operating as an acute-care facility, came out of two years of bankruptcy protection last August. At previous hearings hospital representatives said that a development plan involving the sale of its land was important to its efforts to emerge from its bankruptcy crisis.

“The granting of hardship exemptions has been very rare,” said Mr. Berman, the preservationist. “Up to this point, the hospital has seemed very resistant to opening its books and having its finances transparent.” A spokesman for the hospital declined to comment.

The commissioners’ opposition to the plan amounted to “a good signal to other institutions and to the community that the commission is hearing this,” said Peg Breen, president of the New York Landmarks Conservancy, which had testified against the proposal. “There must be a way for the hospital to get the facility it needs without damaging the integrity of the historic district.”