The Landmarks Preservation Commission seems poised to green light the final hurdle in St. Vincent's Hospital's controversial plan to raze the landmark 1963 O'Toole building in Greenwich Village and replace it with a new hospital and residential towers on both sides of Seventh Avenue. The commission has already approved St. Vincent's designs for the hospital tower, and during a meeting yesterday, revised designs that shorten the tallest residential tower from 266 feet to 218 feet were deemed "fundamentally appropriate." The Rudin Organization plans to create some 375 residential units on and around the spot where the O'Toole building stands; the developer will pay St. Vincent's $310 million for the property, which the hospital will put toward the $830 million cost of a new medical tower. If the LPC approves the residential development next month, then it's the city Planning Commission and the City Council's turn. But die-hard opponents like Andrew Berman of the Greenwich Village Society for Historic Preservation tell the Post, "It's a massive change that's being proposed and I think there are some fears and concerns about the scale of development and whether or not they match the character of Greenwich Village."