MAME and WinCab will both play sound at the same time, although it's possible that your results may vary based on your sound card's mixer. (Note that I haven't tested this since about beta 4, so there's a possibility that changes in MAME or WinCab make this no longer true... I'll check it out when I get home.)
To get WinCab playing with no sound in MAME, you'll have to disable the sound in MAME.
WinCab can adapt to just about any control configuration, even down to a Pac-Man machine with a single joystick and a start button. Tell me what controls you have and what type of monitor you're running and I can make more specific suggestions.
--Chris