An Bord Pleanála has rejected planning permission for the proposed National Children's Hospital in Dublin.
The board said the proposed development "constitute overdevelopment" and would result in "a dominant visually incongruous structure".
The board also said it would have a profound negative impact on the appearance and visual amenity of the city skyline.
Construction of the €650 million hospital on the Mater site was due to be completed in 2016 and would have been the largest building project in Ireland.
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