Cuckoo.
There’s a new toastycode product out today: Cuckoo brings customizable hourly chimes to your Mac. Mac OS X supports speaking the time on the hour using text-to-speech, but there’s no way to just play a simple sound on the hour. Cuckoo will play your choice of sound on the hour, or at any five-minute mark (:05, :10, etc.). You can decrease the volume of the chime relative to your other system sounds, allowing a little subtlety (should you want it).
Basic usage (an hourly chime from the built-in sound set) is free; advanced features cost a measly $6. As usual, please send in your suggestions and bug reports.