Add raw macaroni, browned pork sausage, tomato paste, water, seasonings, and cottage cheese to casserole dish.
Stir well.
Top with as much cheese as you'd like. Adding several different kinds such as mozzarella, parmesan and cheddar makes for a fantastic flavor.
Cover with lid or aluminum foil and bake for 1 hour at 375 degrees. If you're doubling it, I would add an extra 15-20 minutes to the bake time or the noodles might be a little rubbery.
Notes
I would recommend a 7 qt baking dish for making this recipe as it's written. However, it's simple to double or triple if you have a large family or are cooking for a crowd. Just make sure you have a large enough dish - keep in mind the macaroni will expand a little as it bakes. This recipe easily reheats and even tastes better the second or third time as the flavors have melded together. I double this recipe for our family of 7 to make enough for a meal and a couple leftover meals.